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1972135119
MARISOL JACKSON
MARTINEZ, CA
NPI
1972135119
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95012702)
Enumeration Date
2020-02-05
Last Update Date
2020-02-05
Business Address
MARISOL JACKSON
150 MUIR RD
MARTINEZ, CA 94553-4668
Phone number: 925-372-2000
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Mailing Address
MARISOL JACKSON
101 EL BONITO WAY
BENICIA, CA 94510-2216
Phone number: 707-246-2440
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