Tashaka Jack, LVN

NPI 1861044828 · on the registry since 2019

Practice

Address: 4900 Serrania Ave
Woodland Hills, CA 91364
Phone: (818) 347-1577
Organisation at this address: Pacific Lodge Youth Services
Optimist Boys Home & Ranch, Inc.
Optimist Boys' Home & Ranch, Inc.
Optimist Boys' Home And Ranch, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 79

Additional practice sites

4900 Serrania Ave, Woodland Hills, CA

Registry record

Primary taxonomy: 164X00000X
164X00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2019-07-10

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