Most Relevant Information
Provider Data
| NPI Number: | 1003372772 |
| Provider Name: | JAMIKA JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 167G00000X |
| Specialty: | Licensed Psychiatric Technician |
| License Number: | 41047 |
Most Important Dates
| Enumeration Date: | 02/18/2019 |
| Last Updated: | 07/31/2024 |
Provider Practice Location
17270 ROOSEVELT ST
RIVERSIDE
CA
925089523
Practice Location Phone/Fax
| Phone: | 9516836596 |
| Fax: |
Provider Mailing Location
5870 ARLINGTON AVE
RIVERSIDE
CA
925042037
Provider Mailing Phone/Fax
| Phone: | 9516836596 |
| Fax: |