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Robert Terrell Jackson, DIABETESLSCOACH
Counselor in Corona, California
NPI 1851865034

Robert Terrell Jackson is a Counselor based in Artesia, CA. Robert Terrell Jackson practices in Corona, CA and has the professional credentials of DIABETESLSCOACH. The NPI Number for Robert Terrell Jackson is 1851865034 and holds a License No. (California).

The current practice location address for Robert Terrell Jackson is 650 S Main St, Corona, CA and can be reached out via phone at 951-642-0341. You can also correspond with Robert Terrell Jackson through the mailing address at PO BOX 821, ARTESIA, CA - 90702-0821 (mailing address contact number: 951-642-0341).

Location: 650 S Main St, Corona, CA, 90702-0821
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851865034
Provider Name
Robert Terrell Jackson
Credential
DIABETESLSCOACH
Provider Entity Type
Individual
Gender
Male
Address
650 S Main St, Corona, CA, 90702-0821
Phone Number
951-642-0341
Fax Number
Provider Enumeration Date
01/21/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1558583427 01 CA RD,CDE IN THE PROCESS OF REAPPLYING FOR MEDICARE
institution
Provider Business Practice Location Address Details
Address
650 S Main St
City
Corona
State
California
Zip
92882-3417
Phone Number
951-642-0341
Fax Number
person
Provider Business Mailing Address Details
Address
650 S Main St
City
Corona
State
California
Zip
92882-3417
Phone Number
951-642-0341
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
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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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