Individual provider · NPI-1
Christa Lynn Jackson, R.D.H.A.P.
Dental Hygienist · Studio City, CA
NPI number1285942243
StatusActive
Last updated in NPPESJun 2, 2023
Details
- NPI
- 1285942243
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Christa Lynn Jackson
- Credential
- R.D.H.A.P.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 23, 2010
- Certification date
- Jun 2, 2023
- Last updated
- Jun 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | HAP314 | CA | Yes |
Practice location
4508 Saint Clair AvenueStudio City, CA 91604
Phone 818-269-8898 · Fax 818-506-2595
Mailing address
4508 Saint Clair AvenueStudio City, CA 91604
Phone 818-269-8898 · Fax 818-506-2595
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