TIENNA STEPHANIE JACKSON

SAN DIEGO, CA
NPI1194976225
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  89122)
Additional Taxonomies101YM0800X Counselor, Mental Health
1041C0700X Social Worker, Clinical
390200000X Student in an Organized Health Care Education/Training Program
101Y00000X Counselor
Enumeration Date2008-10-07
Last Update Date2024-06-27
Business Address
Mrs. TIENNA STEPHANIE JACKSON
3132 JEFFERSON ST
SAN DIEGO, CA 92110-4421
Phone number: 619-683-3100
Mailing Address
Mrs. TIENNA STEPHANIE JACKSON
3132 JEFFERSON ST
SAN DIEGO, CA 92110-4421
Phone number: 619-683-3100