JACKSON TEA

ANAHEIM, CA
NPI1477365997
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA  95033550)
Enumeration Date2025-01-22
Last Update Date2025-04-15
Business Address
JACKSON TEA MSN, PMHNP-BC
1720 W BALL RD STE 4C
ANAHEIM, CA 92804-5591
Phone number: 714-683-1472
Mailing Address
JACKSON TEA MSN, PMHNP-BC
734 LANTANA ST
LA VERNE, CA 91750-5727
Phone number: 626-429-0088
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