person
Jackson Wall, APCC,AMFT
Mental Health Counselor in Santa Monica, California
NPI 1518577790

Jackson Wall is a Mental Health Counselor based in Redondo Beach, CA and is specialized in Mental Health. Jackson Wall practices in Santa Monica, CA and has the professional credentials of APCC,AMFT. The NPI Number for Jackson Wall is 1518577790 and holds a License No. AMFT120524 (California).

The current practice location address for Jackson Wall is 1450 20Th St, Santa Monica, CA and can be reached out via phone at 310-309-6001.

Location: 1450 20Th St, Santa Monica, CA, 90278-0113
person
Provider Profile Details
NPI Number
1518577790
Provider Name
Jackson Wall
Credential
APCC,AMFT
Provider Entity Type
Individual
Gender
Male
Address
1450 20Th St, Santa Monica, CA, 90278-0113
Phone Number
310-309-6001
Fax Number
Provider Enumeration Date
08/03/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1450 20Th St
City
State
Zip
90404-2906
Phone Number
310-309-6001
Fax Number
person
Provider Business Mailing Address Details
Address
1450 20Th St
City
State
Zip
90404-2906
Phone Number
310-309-6001
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
AMFT120524 (California)
Definition
Definition to come...
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