Individual provider · Type 1 NPI

Theo Jackson

Addiction (Substance Use Disorder) Counselor · Santa Cruz, CA

NPI number 1083966261 Active

Practice location

200 7th Ave
Santa Cruz, CA 95062-4668

Call (831) 462-1060 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1083966261

Theo Jackson's National Provider Identifier is 1083966261, issued on Oct 11, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Santa Cruz, CA. The record was last updated on Oct 11, 2012.