person
Charleston R Jackson
Addiction (Substance Use Disorder) Counselor in Westlake Village, California
NPI 1528288107

Charleston R Jackson is an Addiction (Substance Use Disorder) Counselor based in Van Nuys, CA and is specialized in Addiction (Substance Use Disorder). Charleston R Jackson practices in Westlake Village, CA. The NPI Number for Charleston R Jackson is 1528288107 and holds a License No. (California).

The current practice location address for Charleston R Jackson is 5655 Lindero Canyon Rd Ste 302, Westlake Village, CA and can be reached out via phone at 818-997-6876.

Location: 5655 Lindero Canyon Rd Ste 302, Westlake Village, CA, 91402-4432
person
Provider Profile Details
NPI Number
1528288107
Provider Name
Charleston R Jackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
5655 Lindero Canyon Rd Ste 302, Westlake Village, CA, 91402-4432
Phone Number
818-997-6876
Fax Number
Provider Enumeration Date
04/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7112 01 CA PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
5655 Lindero Canyon Rd Ste 302
City
State
Zip
91362-4045
Phone Number
818-997-6876
Fax Number
person
Provider Business Mailing Address Details
Address
5655 Lindero Canyon Rd Ste 302
City
State
Zip
91362-4045
Phone Number
818-997-6876
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
(California)
Definition
Definition to come...
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