Provider Demographics
NPI:1093056954
Name:HARRIS-JACKSON, YOLANDA FRANCES
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:FRANCES
Last Name:HARRIS-JACKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-3918
Mailing Address - Country:US
Mailing Address - Phone:323-273-1768
Mailing Address - Fax:
Practice Address - Street 1:5838 OVERHILL DR
Practice Address - Street 2:SUITE #3
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2725
Practice Address - Country:US
Practice Address - Phone:323-295-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)