SearchCalifornia106S00000X

Jerrelle Waters Jackson

NPI 1831911742 · on the registry since 2024 · sole proprietor

Practice

Address
23 Harbor Rd # 23
San Francisco, CA 94124
Phone
(650) 770-3917

Registry record

Primary taxonomy
106S00000X
106S00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-10-30

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