Mylisa Jackson

NPI #1205466869 in Lompoc, California

Provider Information

NPI Number: 1205466869
Entity Type: Individual
Name: Mylisa Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Jan 23, 2020
Last Updated: Jan 23, 2020

Practice Location

Address: 401 E CYPRESS AVE
City: Lompoc
State: California
ZIP Code: 93436-6806
Phone: (805) 865-1940

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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