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1346476637
RICHARD JACKSON
SAN CARLOS, CA
NPI
1346476637
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-06-01
Last Update Date
2009-06-01
Business Address
-- RICHARD JACKSON
957 INDUSTRIAL RD SUITE B
SAN CARLOS, CA 94070-4151
Phone number: 415-375-1628
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Mailing Address
-- RICHARD JACKSON
841 SAN BRUNO AVE W
SAN BRUNO, CA 94066-3443
Phone number: 415-375-7628
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