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Contact Information

KALYSE D JACKSON, RN, NP
1405 W RANCHO VISTA BLVD
PALMDALE, CA93551-3968
 Phone: 373-783-9423
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Obstetric, Inpatient

163WX0003X
Indicates primary specialty

NPI Profile & details for KALYSE D JACKSON · (Female)

NPI # 1801427448
Status Active
Credentials RN, NP
Entity Individual
Enumeration date 02/02/2020
Last updated 03/19/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 837226
  • CA License # 95014247
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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