Jackson, Tatiana

Jackson, Tatiana is an individual health care provider with primary practice located at 1212 N California St , Stockton CA 95202-1552. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Jackson, Tatiana can be contacted via phone (209) 468-8786.

Contact Information

Primary practice address
1212 N California St Stockton CA 95202-1552
Phone: (209) 468-8786
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Peer Specialist 175T00000X
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1285266171
LBN Legal business name Jackson, Tatiana
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2020
Last updated Jan 8th, 2024 - about 2 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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