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Crystal Amber Jackson
Addiction (Substance Use Disorder) Counselor in Santa Maria, California
NPI 1821729880

Crystal Amber Jackson is an Addiction (Substance Use Disorder) Counselor based in Santa Maria, CA and is specialized in Addiction (Substance Use Disorder). Crystal Amber Jackson practices in Santa Maria, CA. The NPI Number for Crystal Amber Jackson is 1821729880 and holds a License No. R1452921221 (California).

The current practice location address for Crystal Amber Jackson is 412 E Tunnell St, Santa Maria, CA and can be reached out via phone at 805-925-0315.

Location: 412 E Tunnell St, Santa Maria, CA, 93458-7729
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821729880
Provider Name
Crystal Amber Jackson
Credential
Provider Entity Type
Individual
Gender
Female
Address
412 E Tunnell St, Santa Maria, CA, 93458-7729
Phone Number
805-925-0315
Fax Number
Provider Enumeration Date
06/21/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1033665526 05 CA
institution
Provider Business Practice Location Address Details
Address
412 E Tunnell St
City
Santa Maria
State
California
Zip
93454-4146
Phone Number
805-925-0315
Fax Number
person
Provider Business Mailing Address Details
Address
412 E Tunnell St
City
Santa Maria
State
California
Zip
93454-4146
Phone Number
805-925-0315
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
R1452921221 (California)
Definition
Definition to come...
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