LARICA FANTASIA JACKO

SAN JOSE, CA
NPI1639684228
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101Y00000X Counselor
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2017-12-05
Last Update Date2017-12-05
Business Address
LARICA FANTASIA JACKO
1400 PARKMOOR AVE
SAN JOSE, CA 95126-3797
Phone number: 408-637-8009
Mailing Address
LARICA FANTASIA JACKO
1400 PARKMOOR AVE
SAN JOSE, CA 95126-3797
Phone number: 408-637-8009
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