Jackson, Anisha Nicole

Jackson, Anisha Nicole is an individual health care provider with primary practice located at 2573 W Florida Ave , Hemet CA 92545. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jackson, Anisha Nicole can be contacted via phone (951) 658-7289.

Contact Information

Primary practice address
2573 W Florida Ave Hemet CA 92545
Phone: (951) 658-7289
Fax: (951) 756-5004
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 56906 California

Profile Details

NPI number 1174760961
LBN Legal business name Jackson, Anisha Nicole
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2009
Last updated Sep 30th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174760961 NPPES
California Other 56906 STATE CA LICENSE

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