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1396324554
ANTHONY X JACKSON
SACRAMENTO, CA
NPI
1396324554
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA Ci37710323)
Enumeration Date
2021-04-05
Last Update Date
2024-08-13
Business Address
ANTHONY X JACKSON
1550 JULIESSE AVE
SACRAMENTO, CA 95815-1803
Phone number: 916-921-6598
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Mailing Address
ANTHONY X JACKSON
1550 JULIESSE AVE
SACRAMENTO, CA 95815-1803
Phone number: 916-921-6598
Copy
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