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1134331259
COLLEEN DELORES JACKSON
WEST HOLLYWOOD, CA
NPI
1134331259
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 12835)
Enumeration Date
2007-05-03
Last Update Date
2007-07-08
Business Address
Ms. COLLEEN DELORES JACKSON Nurse Practitioner
8700 BEVERLY BLVD THALIANS 2W, RM 218
WEST HOLLYWOOD, CA 90048-1804
Phone number: 310-423-8572
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Mailing Address
Ms. COLLEEN DELORES JACKSON Nurse Practitioner
849 MANZANITA AVE
PASADENA, CA 91103-2961
Phone number: 310-423-8572
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