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NPI Code Detail

MEDICARE: JAZMIN M. JACKSON LCSW

MEDICARE: JAZMIN M. JACKSON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerTX

General Provider Information

NPI Number : 1245529254
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAZMIN M. JACKSON LCSW
Provider Business Mailing Address
First Line : 3750 COMMERCIAL AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78221-3117
Country : US
Telephone Number : 210-922-7000
Fax Number : 210-457-3392
Provider Business Practice Location Address
First Line : 5439 RAY ELLISON BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78242-2219
Country : US
Telephone Number : 210-922-7000
Fax Number : 210-457-3392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2011
Last Update Date : 10/03/2024

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Directions to “ JAZMIN M. JACKSON LCSW” Practice Location

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