| Jackson Family Therapy Llc | |
|
17565 El Cajon Dr Hesperia CA 92345-7218 | |
| (760) 979-8058 | |
| Not Available |
| Full Name | Jackson Family Therapy Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 17565 El Cajon Dr, Hesperia, California |
| Authorized Official Name and Position | Andre Nakromba Jackson (OWNER) |
| Authorized Official Contact | 6199494476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Family Therapy Llc 17565 El Cajon Dr Hesperia CA 92345-7218 Ph: (760) 979-8058 | Jackson Family Therapy Llc 17565 El Cajon Dr Hesperia CA 92345-7218 Ph: (760) 979-8058 |
| NPI Number | 1043925266 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 01/23/2023 |
| Certification Date | 01/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043925266 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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