Individual provider · Type 1 NPI

Diana Jackson

Mental Health Counselor · Tracy, CA

NPI number 1942423959 Active

Practice location

19 E 6th St
Tracy, CA 95376-4107

Fax (209) 956-4245

Mailing address

15555 Warfield Rd
Lathrop, CA 95330-9492

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XIMF 42420 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1942423959

Diana Jackson's National Provider Identifier is 1942423959, issued on Apr 10, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Tracy, CA. The record was last updated on Jul 8, 2007.