Jackson, Tony
Jackson, Tony is an individual health care provider with primary practice located at 300 E 15Th St , Merced CA 95341-6217. He recently has only one registered license in Nursing Service Providers / Licensed Psychiatric Technician, which is considered as his primary health care specialty. Jackson, Tony can be contacted via phone (209) 381-6879.Contact Information
Primary practice address
300 E 15Th St
Merced CA 95341-6217
Phone: (209) 381-6879
Fax: (209) 725-3775
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Licensed Psychiatric Technician | 167G00000X | 36316 | California |
Profile Details
NPI number | 1225424211 |
---|---|
LBN Legal business name | Jackson, Tony |
Credentials | LPT |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 7th, 2015 |
Last updated | Apr 7th, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1225424211 | NPPES |
California | MEDICAID | 1013030808 |
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