Provider Demographics
NPI:1982199592
Name:JACKSON, JOYTONIA (DOULA)
Entity Type:Individual
Prefix:
First Name:JOYTONIA
Middle Name:
Last Name:JACKSON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 FRANKLIN WAY
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-7369
Mailing Address - Country:US
Mailing Address - Phone:760-590-4174
Mailing Address - Fax:
Practice Address - Street 1:598 W GRANGEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-2800
Practice Address - Country:US
Practice Address - Phone:760-590-4174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula