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NPI Code Detail

MEDICARE: MRS. MONIQUE QUAI JACKSON

MEDICARE: MRS. MONIQUE QUAI JACKSON
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1811760085
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MONIQUE QUAI JACKSON
Provider Business Mailing Address
First Line : 390 40TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-2633
Country : US
Telephone Number : 510-613-0330
Fax Number :
Provider Business Practice Location Address
First Line : 390 40TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-2633
Country : US
Telephone Number : 510-613-0330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2023
Last Update Date : 03/09/2026

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Directions to “ MRS. MONIQUE QUAI JACKSON ” Practice Location

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