MS. DIMITRIA ELISE JACKSON NPI 1679758478

NPI Information

MS. Dimitria Elise Jackson is a specialist in Oakland, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MS. Dimitria Elise Jackson NPI is 1679758478. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6955 FOOTHILL BLVD.
SUITE 300
OAKLAND, CA
ZIP 94605-421
Phone: (510) 577-1906
Fax: (510) 577-5618

The enumeration date for this NPI number is 12/31/2007 and was last updated on 12/31/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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