Bryon D Jackson, CAARR
Counselor, Addiction (Substance Use Disorder) in Los Angeles, CA. Individual provider (NPI-1).
NPI number1124366133
StatusActive
Last updated in NPPESJan 25, 2013
Details
- NPI
- 1124366133
- Entity type
- Individual (NPI-1)
- Name
- Bryon D Jackson
- Credential
- CAARR
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 25, 2013
- Last updated
- Jan 25, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
5930 S Main St#104
Los Angeles, CA 90003-1284
Phone 323-372-5900
Mailing address
5930 S. Main Street#104
Los Angeles, CA 90003
Phone 323-372-5900
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