Individual provider · Type 1 NPI

Judith Ann Jackson

Mental Health Counselor · Santa Cruz, CA

NPI number 1104100775 Active

Practice location

1400 Emeline Ave
Santa Cruz, CA 95060-1976

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1104100775

Judith Ann Jackson's National Provider Identifier is 1104100775, issued on Sep 30, 2011. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Santa Cruz, CA. The record was last updated on Nov 1, 2012.