Jackson, Tori Consuelo

Jackson, Tori Consuelo is an individual health care provider with primary practice located at 960 N State St Ste B , Hemet CA 92543-1473. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Jackson, Tori Consuelo can be contacted via phone (951) 652-3560.

Contact Information

Primary practice address
960 N State St Ste B Hemet CA 92543-1473
Phone: (951) 652-3560
Fax: (951) 929-2780
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1649307562
LBN Legal business name Jackson, Tori Consuelo
Credentials RAS
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Jul 9th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1649307562 NPPES
California MEDICAID 1726

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