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LYNETTE JACKSON

Individual Provider (NPI-1) Active

Counselor, Mental Health

Provider Information

NPI Number
1154288256
Provider Type
Individual Provider (NPI-1)
Status
Active

Contact & Location

Address
2200 STANDIFORD AVE APT 126, MODESTO, CA, 953506540
Phone
(209) 569-3351
Fax
(209) 290-3587

Specialties & Taxonomies

Counselor, Addiction (Substance Use Disorder) License: CA #202030210947
Health & Wellness Coach License: CA #202030210947
Contractor License: CA #202030210947
Case Manager/Care Coordinator License: CA #202030210947
Health Educator License: CA #202030210947
Home Health License: CA #202030210947
Homeopath License: CA #202030210947
Local Education Agency (LEA) License: CA #202030210947
Residential Treatment Facility, Intellectual and/or Developmental Disabilities License: CA #202030210947
Case Management License: CA #202030210947
Counselor, Mental Health Primary License: CA #202030210947

All Addresses

MAILING

2200 STANDIFORD AVE APT 126

MODESTO, CA, 953506540

(209) 569-3351

LOCATION

2200 STANDIFORD AVE APT 126

MODESTO, CA, 953506540

(209) 569-3351