Lisa Ann Jackson is a Counselor based in Fairfield, CA. Lisa Ann Jackson practices in Fairfield, CA. The NPI Number for Lisa Ann Jackson is 1659980738 and holds a License No. (California).
The current practice location address for Lisa Ann Jackson is 956 E Tabor Ave, Fairfield, CA and can be reached out via phone at 707-555-1212.
Location: 956 E Tabor Ave, Fairfield, CA, 94533-4104
Provider Profile Details
NPI Number
1659980738
Provider Name
Lisa Ann Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
956 E Tabor Ave, Fairfield, CA, 94533-4104
Phone Number
707-555-1212
Fax Number
Provider Enumeration Date
07/24/2020
Last Update Date
03/10/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90577107F64129 | 05 | CA |
Provider Business Practice Location Address Details
Address
956 E Tabor Ave
City
State
Zip
94533-4104
Phone Number
707-555-1212
Fax Number
Provider Business Mailing Address Details
Address
956 E Tabor Ave
City
State
Zip
94533-4104
Phone Number
707-555-1212
Fax Number
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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