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Jimmie Lee Jackson JR.
Peer Specialist in San Diego, California
NPI 1124513783

Jimmie Lee Jackson JR. is a Peer Specialist based in San Diego, CA. Jimmie Lee Jackson JR. practices in San Diego, CA. The NPI Number for Jimmie Lee Jackson JR. is 1124513783 and holds a License No. (California).

The current practice location address for Jimmie Lee Jackson JR. is 1260 Morena Blvd Ste 100, San Diego, CA and can be reached out via phone at 619-398-0355.

Location: 1260 Morena Blvd Ste 100, San Diego, CA, 92110-3850
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124513783
Provider Name
Jimmie Lee Jackson JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
1260 Morena Blvd Ste 100, San Diego, CA, 92110-3850
Phone Number
619-398-0355
Fax Number
Provider Enumeration Date
06/26/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1260 Morena Blvd Ste 100
City
San Diego
State
California
Zip
92110
Phone Number
619-398-0355
Fax Number
person
Provider Business Mailing Address Details
Address
1260 Morena Blvd Ste 100
City
San Diego
State
California
Zip
92110
Phone Number
619-398-0355
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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