MIA LANISE JACKSON

MISSION VIEJO, CA
NPI1609598408
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164X00000X Licensed Vocational Nurse
(Licence: CA  689359)
Enumeration Date2022-09-19
Last Update Date2026-08-11
Business Address
MIA LANISE JACKSON LVN
26921 CROWN VALLEY PKWY STE 200
MISSION VIEJO, CA 92691-6501
Phone number: 949-334-8288
Mailing Address
MIA LANISE JACKSON LVN
34264 CHAPAROSSA DR
LAKE ELSINORE, CA 92532-2919
Phone number: 951-259-6061
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