FREDERICK JACKSON

CONCORD, CA
NPI1225574759
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1239870916)
Enumeration Date2017-01-08
Last Update Date2017-01-08
Business Address
-- FREDERICK JACKSON
2090 COMMERCE AVE
CONCORD, CA 94520-4902
Phone number: 925-676-2580
Mailing Address
-- FREDERICK JACKSON
2090 COMMERCE AVE
CONCORD, CA 94520-4902
Phone number: 925-676-2580
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