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1730901836
FATEEN LATEEF JACKSON
FAIRFIELD, CA
NPI
1730901836
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2024-10-29
Last Update Date
2024-10-29
Business Address
FATEEN LATEEF JACKSON
2101 COURAGE DR
FAIRFIELD, CA 94533-6717
Phone number: 707-646-4600
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Mailing Address
FATEEN LATEEF JACKSON
2101 COURAGE DR
FAIRFIELD, CA 94533-6717
Phone number: 707-646-4600
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