Search › California › 101Y00000X
Shannon Jackson
NPI 1558742395 · on the registry since 2015
Practice
- Address
- 4990 Williams Ave
La Mesa, CA 91942 - Phone
- (619) 668-4265
- Fax
- (619) 668-4264
- Organisation at this address
- Vista Hill Foundation
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 48
Registry record
- Primary taxonomy
- 101Y00000X
101Y00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2015-06-17
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