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1134798317
PHENIX JACKSON
SAN JOSE, CA
NPI
1134798317
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-06-22
Last Update Date
2021-06-22
Business Address
PHENIX JACKSON
1887 MONTEREY HWY STE 225
SAN JOSE, CA 95112-6192
Phone number: 855-223-7123
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Mailing Address
PHENIX JACKSON
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 855-223-7123
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