Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LISA JACKSON
ActiveLISA JACKSON is a 376G00000X healthcare provider located in FRESNO, California. NPI 1053029017 is currently active in the NPPES registry. Verify at CMS.
376G00000X · FRESNO, CA
Registration Details
- NPI Number
- 1053029017
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 9, 2022 (3.7972017116624 yrs)
- Last Updated
- Nov 9, 2022
Practice Information
- Address
-
8050 N PALM AVE STE 300FRESNO, CA, 937115510Browse CA providers · Browse ZIP 93711
- Phone
- 8669810656
- Fax
- 8665715484
- Primary Specialty
-
376G00000X
376G00000X
Other 376G00000X Providers in FRESNO, CA
| Name | Credential | NPI |
|---|---|---|
| MR. GREGORY AIFEHIENGBE IDONI | — | 1003231523 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.