Jackson, Frederick

Jackson, Frederick is an individual health care provider with primary practice located at 2090 Commerce Ave , Concord CA 94520-4902. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Jackson, Frederick can be contacted via phone (925) 676-2580.

Contact Information

Primary practice address
2090 Commerce Ave Concord CA 94520-4902
Phone: (925) 676-2580
Fax: (925) 798-3359
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X R1239870916 California

Profile Details

NPI number 1225574759
LBN Legal business name Jackson, Frederick
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2017
Last updated Jan 8th, 2017 - about 9 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 1225574759 NPPES
California Other R1239870916 CCAPP

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