Individual provider · Type 1 NPI
Steven Jackson
Lodging Provider · Stockton, CA
NPI number
1831086388
Active
Practice location
3627 San Rafael Ave
Stockton, CA 95204-2413
Fax (209) 265-0101
Mailing address
1308 Madera Ave
Menlo Park, CA 94025-1508
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Lodging Provider Primary | 177F00000X | None listed |
Lodging Provider: A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
About NPI 1831086388
Steven Jackson's National Provider Identifier is 1831086388, issued on Jun 18, 2025. The primary taxonomy on file is Lodging Provider (177F00000X), and the practice location is in Stockton, CA. The record was last updated on Jun 18, 2025.