DIANA JACKSON

TRACY, CA
NPI1942423959
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CA  IMF 42420)
Enumeration Date2007-04-10
Last Update Date2007-07-08
Business Address
Ms. DIANA JACKSON
19 E 6TH ST
TRACY, CA 95376-4107
Phone number: 209-956-4240
Mailing Address
Ms. DIANA JACKSON
15555 WARFIELD RD
LATHROP, CA 95330-9492
Phone number: 209-612-5752