Jackson, Diana

Jackson, Diana is an individual health care provider with primary practice located at 19 E 6Th St , Tracy CA 95376-4107. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Jackson, Diana can be contacted via phone (209) 956-4240.

Contact Information

Primary practice address
19 E 6Th St Tracy CA 95376-4107
Phone: (209) 956-4240
Fax: (209) 956-4245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X IMF 42420 California

Profile Details

NPI number 1942423959
LBN Legal business name Jackson, Diana
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated Jul 8th, 2007 - about 17 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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