Most Relevant Information
Provider Data
| NPI Number: | 1003437922 |
| Provider Name: | FATIMA JACKSON BS |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/01/2020 |
| Last Updated: | 05/01/2020 |
Provider Practice Location
940 AVENUE 64
PASADENA
CA
911052711
Practice Location Phone/Fax
| Phone: | 3232550978 |
| Fax: |
Provider Mailing Location
815 COLORADO BLVD STE 300
LOS ANGELES
CA
900411744
Provider Mailing Phone/Fax
| Phone: | 3235432800 |
| Fax: | 3239781263 |