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Dalonna Trenae Jackson
Student in an Organized Health Care Education/Training Program in Rio Vista, California
NPI 1215508528

Dalonna Trenae Jackson is a Student in an Organized Health Care Education/Training Program based in East Palo Alto, CA. Dalonna Trenae Jackson practices in Rio Vista, CA. The NPI Number for Dalonna Trenae Jackson is 1215508528 and holds a License No. (California).

The current practice location address for Dalonna Trenae Jackson is 628 Montezuma St, Rio Vista, CA and can be reached out via phone at 707-374-5243.

Location: 628 Montezuma St, Rio Vista, CA, 94303-5700
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215508528
Provider Name
Dalonna Trenae Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
628 Montezuma St, Rio Vista, CA, 94303-5700
Phone Number
707-374-5243
Fax Number
Provider Enumeration Date
07/07/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
628 Montezuma St
City
Rio Vista
State
California
Zip
94571-1622
Phone Number
707-374-5243
Fax Number
person
Provider Business Mailing Address Details
Address
628 Montezuma St
City
Rio Vista
State
California
Zip
94571-1622
Phone Number
707-374-5243
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(California)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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