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NPI 1962909259

IndividualActive

Jatai Jackson

NPI 1962909259 · Community Health Worker · Woodbridge, VA

Provider details

NPI number: 1962909259
Entity type: Individual
Primary specialty: Community Health WorkerOther Service Providers
Sex: Female
Sole proprietor: No
License: 12201 (VA)

Practice location

15022 Sunny Ridge Ct

Woodbridge, VA 22191-3967

Phone: (202) 439-3667

More VA providers

Mailing address

15022 Sunny Ridge Ct Apt 203

Woodbridge, VA 22191-3967

Registry dates

Enumerated: 2018-04-12
Last updated: 2024-12-02

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Jatai Jackson — NPI 1962909259, Woodbridge, VA | NPI Central