KEVIN JACKSON (NPI# 1326498361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326498361 |
| Entity Type | Individual |
| Full Name | KEVIN JACKSON |
| Credential | PA-C |
| Practice Address |
2251 N Harbor Blvd Fullerton CA 92835-2601 |
| Practice Telephone | 7144496230 |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2018-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 190 W Germantown Pike Ste 100, Norristown, PA 194011385 | 6102728221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114456498 | Kevin Thomas Jackson | Counselor | 310 S 49th W Ave, Tulsa, OK 74127 | 2017-06-08 |
| 1164845400 | Kevin Jackson Sr. | Counselor | 621 E Carnagie Dr # 210 San Bernardino Ca 92415, San Bernardino, CA 92415-3919 | 2014-01-22 |
| 1932545449 | Kevin D Jackson | Behavioral Analyst | 4060 Old Plantation Loop, Tallahassee, FL 32311-1306 | 2013-05-13 |
| 1174867634 | Kevin D Jackson | Dentist | 8101 Hinson Farm Rd Ste 216, Alexandria, VA 22306-3406 | 2012-11-21 |
| 1366724270 | Kevin R Jackson | Health Educator | 19752 Snowden St, Detroit, MI 48235-1180 | 2011-09-16 |
| 1376838300 | Kevin Jackson | Counselor | 15108 Doveheart Ln, Bowie, MD 20721-3054 | 2011-06-17 |
| 1881724607 | Kevin Carl Jackson | Optometrist | 7828 Eastern Ave Nw, Washington, DC 20012 | 2007-03-07 |
| 1144291907 | Kevin T Jackson | Family Medicine | 1420 Highway 62 65 N, Harrison, AR 72601-1959 | 2006-01-30 |
| 1316938517 | Kevin Lee Jackson | Internal Medicine | 2430 Village Professional Dr, Opelika, AL 36801-2378 | 2005-11-04 |
| 1588654115 | Kevin Michael Jackson | Optometrist | 39-06 Kramer Pl, Fair Lawn, NJ 07410-5311 | 2005-10-25 |
| Street Address |
2251 N HARBOR BLVD |
| City | FULLERTON |
| State | CA |
| Zip Code | 92835-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790791010 | Bryan-huy Ngoc Phi | Family Medicine | 2251 N Harbor Blvd, Fullerton, CA 92835 | 2006-07-31 |
| 1932666815 | Emi Pham | Physician Assistant | 2251 N Harbor Blvd, Fullerton, CA 92835-2601 | 2019-02-27 |
| 1528196169 | Elethea George Locke-harris | Physician Assistant | 2251 N Harbor Blvd, Fullerton, CA 92835-2601 | 2007-03-02 |
| 1497829972 | Arash Farahanchi | Family Medicine | 2251 N Harbor Blvd, Fullerton, CA 92835-2601 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538774302 | Natalie Baugh | Nutritionist | 333 W Bastanchury Rd 110, Fullerton, CA 92835 | 2020-09-09 |
| 1073127098 | Cecile Mae Sam | Physical Therapist | 2932 Clover Ct, Fullerton, CA 92835 | 2020-09-08 |
| 1861966087 | Kimson F Johnston | Marriage & Family Therapist | 1370 Brea Blvd Suite 210, Fullerton, CA 92835 | 2019-01-22 |
| 1134636327 | Michelle Harriman, Psychologist - A Professional Corporation | Psychologist | 1440 N Harbor Blvd Ste 808, Fullerton, CA 92835 | 2018-01-09 |
| 1659818631 | Jacqueline Rene Miller | Specialist/Technologist | 2610 Associated Rd, Apt A4, Fullerton, CA 92835 | 2017-01-27 |
| 1912361106 | John Nathaniel Alvarez | Psychiatry & Neurology | 401 E Imperial Highway, Fullerton, CA 92835 | 2016-04-13 |
| 1083075030 | Advance Recovery Solution, LLC | Substance Abuse Rehabilitation Facility | 3744 N Hermosa Pl, Fullerton, CA 92835 | 2016-03-17 |
| 1467817981 | Michele Ledesma | Physical Therapy Assistant | 2800 N. Harbor Blvd., Fullerton, CA 92835 | 2015-12-29 |
| 1467820571 | Jonghan Kang | Acupuncturist | 1321 N Harbor Blvd Ste 205, Fullerton, CA 92835 | 2015-09-04 |
| 1265840987 | Allison Leigh Kennedy | Physician Assistant | 100 Laguna Rd Ste 208, Fullerton, CA 92835 | 2014-07-25 |
| Find all providers in zip 92835 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666815 | Emi Pham | Physician Assistant | 2251 N Harbor Blvd, Fullerton, CA 92835-2601 | 2019-02-27 |
| 1205285079 | Jane Wu | Physician Assistant | 901 W Orangethorpe Ave, Fullerton, CA 92832-2826 | 2016-06-12 |
| 1376888735 | Daniel Brian Mcconnell Jr. | Physician Assistant | 101 Laguna Rd, Suite A, Fullerton, CA 92835-3634 | 2012-12-11 |
| 1962787838 | Julie B Hastin | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2011-10-11 |
| 1306154604 | Rebecca Schilleci | Physician Assistant | 101 Laguna Rd, Suite A, Fullerton, CA 92835-3634 | 2010-09-21 |
| 1215118641 | Deirdre T Moxley | Physician Assistant | 1950 Sunnycrest Dr, Suite 2300, Fullerton, CA 92835-3638 | 2007-11-14 |
| 1063692366 | Kendra Higgins | Physician Assistant | 680 Langsdorf Dr, Suite 103, Fullerton, CA 92831-3702 | 2007-11-05 |
| 1932388840 | Jaime Neri Jr. | Physician Assistant | 2720 N Harbor Blvd, Suite 130, Fullerton, CA 92835-2609 | 2007-10-26 |
| 1831227610 | Jason Robert Cook | Physician Assistant | 2720 N Harbor Blvd, Suite 130, Fullerton, CA 92835-2609 | 2007-03-01 |
| 1902949951 | Pk Logan | Physician Assistant | 150 Laguna Rd, Fullerton, CA 92835-3614 | 2007-02-15 |
| Find all providers in FULLERTON | ||||
Please comment or provide details below to improve the information on KEVIN JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.