Individual provider · Type 1 NPI

Richard Jackson

Mental Health Counselor · San Carlos, CA

NPI number 1346476637 Active

Practice location

957 Industrial Rd, Suite B
San Carlos, CA 94070-4151

Call (415) 375-1628 Map

Mailing address

841 San Bruno Ave W
San Bruno, CA 94066-3443

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1346476637

Richard Jackson's National Provider Identifier is 1346476637, issued on Jun 1, 2009. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Carlos, CA. The record was last updated on Jun 1, 2009.