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Lara Jeanne Jackson, LMFT
Mental Health Counselor in Vista, California
NPI 1669186490

Lara Jeanne Jackson is a Mental Health Counselor based in Vista, CA and is specialized in Mental Health. Lara Jeanne Jackson practices in Vista, CA and has the professional credentials of LMFT. The NPI Number for Lara Jeanne Jackson is 1669186490 and holds a License No. 360881 (California).

The current practice location address for Lara Jeanne Jackson is 1938 Intrepid Way, Vista, CA and can be reached out via phone at 760-419-6556.

Location: 1938 Intrepid Way, Vista, CA, 92081-7037
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669186490
Provider Name
Lara Jeanne Jackson
Credential
LMFT
Provider Entity Type
Individual
Gender
Female
Address
1938 Intrepid Way, Vista, CA, 92081-7037
Phone Number
760-419-6556
Fax Number
Provider Enumeration Date
01/06/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1938 Intrepid Way
City
Vista
State
California
Zip
92081-7037
Phone Number
760-419-6556
Fax Number
person
Provider Business Mailing Address Details
Address
1938 Intrepid Way
City
Vista
State
California
Zip
92081-7037
Phone Number
760-419-6556
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
360881 (California)
Definition
Definition to come...
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