Steven Bryce Jackson
Emergency Medical Technician, Basic in Fresno, CA. Individual provider (NPI-1).
NPI number1104581024
StatusActive
Last updated in NPPESNov 4, 2021
Details
- NPI
- 1104581024
- Entity type
- Individual (NPI-1)
- Name
- Steven Bryce Jackson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 4, 2021
- Certification date
- Nov 4, 2021
- Last updated
- Nov 4, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 146N00000X | Emergency Medical Technician, Basic | E161521 | CA | Yes |
Practice location
900 W Belgravia AveFresno, CA 93706-3909
Phone 559-265-2045
Mailing address
900 W Belgravia AveFresno, CA 93706-3909
Phone 559-265-2045
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