NPI 1104577147
Angelique Allyssa Jackson
Practice location
- Address
- 2122 S El Camino Real STE 201, Oceanside, CA 92054-6210
- Phone
- (760) 290-8170
- Fax
- (760) 439-0019
Registered specialties
Peer Specialist
Primary
Registry record
- NPI
- 1104577147
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 11 Jan 2022
- Record last updated
- 11 Jan 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.