MAIDA ELENA JACKSON FNP
NPI 1043945157
Nurse Practitioner - Family in Los Angeles, CA
Active since July 21, 2022
About Maida Elena Jackson Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAIDA ELENA JACKSON FNP (NPI 1043945157) is an individual family provider in Los Angeles, California, licensed in California (95015651) and active in the NPI registry since July 2022.
NPPES Registry Identity
NPI1043945157
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMAIDA ELENA JACKSONCredential: FNP
Location Address3612 1/2 E 1ST STLos Angeles, CA 90063-2326
Mailing Address6137 E Dayton AveFresno, CA 93727-8937 · (559) 473-7943
Phone(323) 264-7796
Fax(323) 264-7778
Sole ProprietorNo
Enumeration DateJuly 21, 2022
NPPES CertifiedJuly 21, 2022
✔ NPI 1043945157 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95015651
3612 1/2 E 1ST ST, Los Angeles, CA 90063
Other Names 1
Former Name (1)Maida Rivera
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Internal Medicine (Critical Care Medicine)
3612 1/2 E 1ST ST
LOS ANGELES, CA 90063
LOS ANGELES, CA 90063
Podiatrist (Foot & Ankle Surgery)
3612 1/2 E 1ST ST
LOS ANGELES, CA 90063
LOS ANGELES, CA 90063
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043945157, enumerated as an "individual" on July 21, 2022.
The provider is located at 3612 1/2 E 1ST ST LOS ANGELES, CA 90063 and the phone number is (323) 264-7796.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
