Individual provider · Type 1 NPI

Ty'shunna Jackson

Addiction (Substance Use Disorder) Counselor · Venice, CA

NPI number 1154518835 Active

Practice location

717 Lincoln Blvd
Venice, CA 90291-2845

Call (310) 399-9883 Map

Mailing address

26460 Summit Cir
Santa Clarita, CA 91350-2991

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 1154518835

Ty'shunna Jackson's National Provider Identifier is 1154518835, issued on Sep 26, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Venice, CA. The record was last updated on Sep 26, 2007.