MRS. KALYSE DANAE JACKSON (NPI# 1801427448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801427448 |
| Entity Type | Individual |
| Full Name | MRS. KALYSE DANAE JACKSON |
| Other Name | CALICE DANAE JACKSON |
| Credential | RN, NP |
| Practice Address |
1405 W Rancho Vista Blvd Palmdale CA 93551-3968 |
| Mailing Address |
43943 Catsue Pl Lancaster CA 93536-5566 |
| Practice Telephone | 3737839423 |
| Mailing Telephone | 6614007095 |
| Enumeration Date | 2020-02-02 |
| Last Update Date | 2020-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WX0003X |
Registered Nurse Specialization: Obstetric, Inpatient |
837226 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95014247 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1405 W RANCHO VISTA BLVD |
| City | PALMDALE |
| State | CA |
| Zip Code | 93551-3968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184634107 | Center for Orthopedics & Rehabilitation Medical Group | Chiropractor | 1405 W Rancho Vista Blvd, Palmdale, CA 93551-3968 | 2006-08-09 |
| 1881968907 | Av Pacific Medical Management Inc | Chiropractor | 1405 W Rancho Vista Blvd, Palmdale, CA 93551-3968 | 2012-03-07 |
| 1124038021 | Luigi Kirchmann | Chiropractor | 1405 W Rancho Vista Blvd, Palmdale, CA 93551-3968 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518578251 | Epak LLC | Registered Nurse | 6327 Giovanni Way, Palmdale, CA 93551 | 2020-08-16 |
| 1710500483 | Hmg Community Clinic Inc | Family Medicine | 38900 Trade Center Drive Suite B, Palmdale, CA 93551 | 2020-05-28 |
| 1891338372 | Babak Yousefi & Fariborz Rodef Dental Corporation | Dentist | 623 West Ave Q Suite #b, Palmdale, CA 93551 | 2019-10-28 |
| 1770052748 | The Kibbutz - Nature Serenity Renewal | Clinic/Center | 13136 Elizabeth Lake Rd, Leona Valley, CA 93551 | 2018-11-19 |
| 1306321872 | Vicky Elena Ledesma | Case Manager/Care Coordinator | 251 Grand Cypress Ave, Palmdale, CA 93551 | 2018-10-01 |
| 1972025898 | Tamika Estrella | Driver | 39553 Hawthorne St, Palmdale, CA 93551 | 2017-07-12 |
| 1245750751 | Tamara Vwich Dds Inc | Dentist | 3011 Rancho Vista Blvd., Suite I, Palmdale, CA 93551 | 2017-06-26 |
| 1487003356 | Thriving Consultingname | Home Health | 2845 Ladyfern Lane, Palmdale, CA 93551 | 2016-06-10 |
| 1235501750 | Jessica Andrea Ulloa | Counselor | 734 Celtic Dr, Palmdale, CA 93551 | 2015-10-23 |
| 1508240243 | Rachel Williams | Registered Nurse | 3961 Woburn Ct, Palmdale, CA 93551 | 2015-07-13 |
| Find all providers in zip 93551 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063027514 | Jeff Advincula | Nurse Practitioner | 38460 5th St W Ste D, Palmdale, CA 93551-4685 | 2020-09-11 |
| 1205446903 | Africajun LLC | Nurse Practitioner | 39874 Golfers Dr, Palmdale, CA 93551-2982 | 2020-08-06 |
| 1093366957 | Megan N Wright | Nurse Practitioner | 627 W Avenue Q Ste D, Palmdale, CA 93551-3891 | 2019-09-23 |
| 1386291060 | Martha Collins | Nurse Practitioner | 2271 E Palmdale Blvd Ste E, Palmdale, CA 93550-1340 | 2019-08-19 |
| 1770069585 | Brenda Lynn Zamora | Nurse Practitioner | 1220 E Avenue S Ste D, Palmdale, CA 93550-6196 | 2018-07-15 |
| 1518453778 | Tania Eunice Sedano | Nurse Practitioner | Heritage Health Care Medical Group, 38209 47th St East, Ste C, Palmdale, CA 93552-3112 | 2018-07-10 |
| 1841710886 | Michelle Ledbetter | Nurse Practitioner | 38660 Medical Center Dr Ste A130, Palmdale, CA 93551-4385 | 2017-06-21 |
| 1508239518 | Kathleen (katie) Bridget Kirk | Nurse Practitioner | 41908 Pico Way, Palmdale, CA 93551-4720 | 2015-11-12 |
| 1588045256 | Mankaa Helen Fokwa | Nurse Practitioner | 540 W Palmdale Blvd # B, Palmdale, CA 93551-4232 | 2015-06-17 |
| 1487060463 | Rahmiel H Garfield | Nurse Practitioner | 38713 Tierra Subida Ave # 200-245, Palmdale, CA 93551-4562 | 2014-07-10 |
| Find all providers in PALMDALE | ||||
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| 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.