Search › California › 363LF0000X
Shanna Jackson, NP
NPI 1710506472 · on the registry since 2020
Practice
- Address
- 24060 Fir Ave Ste A
Moreno Valley, CA 92553 - Phone
- (951) 247-8005
- Organisation at this address
- Prime Dx Labs Llc
Nextgen Medical Services Inc
Sarath C Witana Medical Group Inc
Heacock Health Medical Group, Inc.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 6
Additional practice sites
- 12815 Heacock St, Moreno Valley, CA
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Also registered as
- 163W00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-04-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California