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Antoine Jackson
Mental Health Counselor in Orange, California
NPI 1447745088

Antoine Jackson is a Mental Health Counselor based in San Bernardino, CA and is specialized in Mental Health. Antoine Jackson practices in Orange, CA. The NPI Number for Antoine Jackson is 1447745088 and holds a License No. (California).

The current practice location address for Antoine Jackson is 401 S Tustin St, Orange, CA and can be reached out via phone at 714-289-3936.

Location: 401 S Tustin St, Orange, CA, 92407-7027
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1447745088
Provider Name
Antoine Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
401 S Tustin St, Orange, CA, 92407-7027
Phone Number
714-289-3936
Fax Number
Provider Enumeration Date
06/26/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
401 S Tustin St
City
Orange
State
California
Zip
92866-2550
Phone Number
714-289-3936
Fax Number
person
Provider Business Mailing Address Details
Address
401 S Tustin St
City
Orange
State
California
Zip
92866-2550
Phone Number
714-289-3936
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...
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