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1134635824
SHYRA D'ANN JACKSON
RICHMOND, CA
NPI
1134635824
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 12554-R)
Enumeration Date
2017-12-18
Last Update Date
2017-12-18
Business Address
SHYRA D'ANN JACKSON
12960 SAN PABLO AVE
RICHMOND, CA 94805-1307
Phone number: 510-215-2280
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Mailing Address
SHYRA D'ANN JACKSON
1901 CHURCH LN
SAN PABLO, CA 94806-3707
Phone number: 510-215-2280
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