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Andrell Jackson
NPI 1528310919 · on the registry since 2012
Practice
- Address
- 7410 S Broadway
Los Angeles, CA 90003 - Phone
- (323) 751-3026
- Clinicians at this address
- 9
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2012-10-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California