person
Kevin Jackson SR.
Addiction (Substance Use Disorder) Counselor in San Bernardino, California
NPI 1164845400

Kevin Jackson SR. is an Addiction (Substance Use Disorder) Counselor based in San Bernardino, CA and is specialized in Addiction (Substance Use Disorder). Kevin Jackson SR. practices in San Bernardino, CA. The NPI Number for Kevin Jackson SR. is 1164845400 and holds a License No. (California).

The current practice location address for Kevin Jackson SR. is 621 E Carnagie Dr # 210 San Bernardino Ca 92415, San Bernardino, CA and can be reached out via phone at 909-386-9767 and via fax at 909-381-2172.

Location: 621 E Carnagie Dr # 210 San Bernardino Ca 92415, San Bernardino, CA, 92415-0530
person
Provider Profile Details
NPI Number
1164845400
Provider Name
Kevin Jackson SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
621 E Carnagie Dr # 210 San Bernardino Ca 92415, San Bernardino, CA, 92415-0530
Phone Number
909-386-9767
Fax Number
909-381-2172
Provider Enumeration Date
01/22/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
621 E Carnagie Dr # 210 San Bernardino Ca 92415
City
State
Zip
92415-3919
Phone Number
909-386-9767
Fax Number
909-381-2172
person
Provider Business Mailing Address Details
Address
621 E Carnagie Dr # 210 San Bernardino Ca 92415
City
State
Zip
92415-3919
Phone Number
909-386-9767
Fax Number
909-381-2172
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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