Jackson, Courtney Lara

Jackson, Courtney Lara is an individual health care provider with primary practice located at 1801 Vincente St , San Francisco CA 94116-2923. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Jackson, Courtney Lara can be contacted via phone (415) 681-3211.

Contact Information

Primary practice address
1801 Vincente St San Francisco CA 94116-2923
Phone: (415) 681-3211
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1063606846
LBN Legal business name Jackson, Courtney Lara
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2007
Last updated Apr 21st, 2015 - about 10 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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