Kevin Jackson Sr.
Kevin Jackson Sr. is an Addiction (Substance Use Disorder) Counselor in San Bernardino, California. Registered with an NPI since 2014.
- In the registry since
- 2014
Practice location Address checks out
621 E Carnagie Dr # 210 San Bernardino CA 92415San Bernardino, CA 92415-3919
Phone: (909) 386-9767
Fax: (909) 381-2172
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X |
|---|
Record details
| NPI number | 1164845400 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | January 22, 2014 |
| Last updated in NPPES | January 14, 2020 |
| Certification date | January 14, 2020 |
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