Jackson, Ajani Dechaun

Jackson, Ajani Dechaun is an individual health care provider with primary practice located at 1959 Solano Way , Concord CA 94520-5526. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Jackson, Ajani Dechaun can be contacted via phone (925) 676-9768.

Contact Information

Primary practice address
1959 Solano Way Concord CA 94520-5526
Phone: (925) 676-9768
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 150257 Texas
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A131170 California

Profile Details

NPI number 1740411214
LBN Legal business name Jackson, Ajani Dechaun
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2009
Last updated Apr 25th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740411214 NPPES
California MEDICAID 94-2209679

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