Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MIA LANISE JACKSON LVN
NPI 1609598408
Licensed Vocational Nurse in Mission Viejo, CA

Q: What is Mia Jackson's NPI number?

The NPI number for Mia Jackson is 1609598408. It was assigned to this individual provider in the NPPES registry on September 19, 2022.

Q: What is Mia Jackson's specialty?

The primary specialty registered for this NPI is Licensed Vocational Nurse with taxonomy code 164X00000X.

Q: When was this NPI record last updated?

The NPPES record for Mia Jackson was last updated on August 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 19, 2022

26921 CROWN VALLEY PKWY STE 200, MISSION VIEJO, CA 92691(949) 334-8288(949) 334-8294 Get Directions Write a Review

NPPES record last updated: August 11, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 11, 2026, Sep 19, 2022 (2 updates tracked since 2022).

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About Mia Lanise Jackson Lvn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIA LANISE JACKSON LVN (NPI 1609598408) is an individual licensed vocational nurse in Mission Viejo, California, licensed in California (689359) and active in the NPI registry since September 2022.

NPPES Registry Identity

NPI1609598408

Entity TypeIndividualFemale

Primary Taxonomy164X00000X

Provider Legal NameMIA LANISE JACKSONCredential: LVN

Location Address26921 CROWN VALLEY PKWY STE 200Mission Viejo, CA 92691-6501

Mailing Address34264 Chaparossa DrLake Elsinore, CA 92532-2919 · (951) 259-6061

Phone(949) 334-8288

Fax(949) 334-8294

Sole ProprietorYes

Enumeration DateSeptember 19, 2022

Last NPPES UpdateAugust 11, 20262 updates tracked since enumeration

NPPES CertifiedAugust 11, 2026

✔ NPI 1609598408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Vocational NurseNursing Service Providers

Taxonomy Code164X00000X

License✔ Licensed in CA · 689359

Definition

A licensed vocational nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job responsibilities vary among the states.

26921 CROWN VALLEY PKWY STE 200, Mission Viejo, CA 92691

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Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRAD CHRISTOPHER DAVIS

Counselor (Addiction (Substance Use Disorder))