Jackson, Michelle Lorraine

Jackson, Michelle Lorraine is an sole proprietor health care provider with primary practice located at 1421 Guerneville Rd Ste 218 , Santa Rosa CA 95403-7255. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Jackson, Michelle Lorraine can be contacted via phone (707) 576-7700.

Contact Information

Primary practice address
1421 Guerneville Rd Ste 218 Santa Rosa CA 95403-7255
Phone: (707) 576-7700
Fax: (707) 576-7744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X ASW59973 California
Behavioral Health & Social Service Providers / Social Worker 104100000X ASW59973 California

Profile Details

NPI number 1083021968
LBN Legal business name Jackson, Michelle Lorraine
Credentials ASW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 13th, 2014
Last updated May 18th, 2015 - about 11 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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