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1245500131
JACKSON SAUTHOFF
CAMARILLO, CA
NPI
1245500131
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-01-09
Last Update Date
2012-01-09
Business Address
-- JACKSON SAUTHOFF
1756 S LEWIS RD
CAMARILLO, CA 93012-8520
Phone number: 805-383-3669
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Mailing Address
-- JACKSON SAUTHOFF
1040 SANTA CRUZ ISLAND DR APT 27
CAMARILLO, CA 93012-9193
Phone number: 805-383-3669
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