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Contact Information

TRACIE L JACKSON
1274 CENTER COURT DR STE 211
COVINA, CA91724-3668
 Phone: 909-231-5639
 Fax:
 Website:
Indicates primary specialty

NPI Profile & details for TRACIE L JACKSON · (Female)

NPI Number 1275181414
Status Active
Credentials
Entity Individual
Enumeration date 08/30/2019
Last updated 04/03/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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