| Doctor Name: | MR. CURTIS CHARLES JACKSON |
| NPI Number: | 1013139880 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | R.A.S. |
| License Number: | |
| Business Practice Address: | 4645 Pacheco Blvd Martinez, CA - 945533625 |
| Business Phone Number: | 9256469270 |
| Business Fax Number: | 9256469276 |
| Mailing Address: | Po Box 1109, MARTINEZ |
| State: | CA |
| Postal Code: | 945530110 |
| Phone Number: | 9256469270 |
| Fax Number: | 9256469276 |
| NPI Enumeration Date: | 05/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |