Bruce L Jackson, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA14185 Issued in CA

Practice address

15863 Kasota Rd
Apple Valley, CA 92307-4507

Phone

(760) 948-1454

Fax

(760) 948-6100

NPI assigned

May 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bruce.jackson.p4@direct.fpa.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1639066491

  CA

  Medicare reassignment Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ontario, CA
  • NPI 1215494257
  Care Compare group NPD
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Fontana, CA
  • NPI 1003373812
  Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1043777089
  Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ontario, CA
  • NPI 1093369340
  Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1205393238
  Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Corona, CA
  • NPI 1265999296
  Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1720571789
  Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1730748922
  Care Compare group
• Unicare Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Moreno Valley, CA
  • NPI 1881151827
  Care Compare group
• Unicare Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fontana, CA
  • NPI 1174984041
  Care Compare group
• Unicare Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1265854061
  Care Compare group

Specialty

Physician Assistant

Education

University of Southern California Keck School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unicare Community Health Center, Inc. 64 clinicians

Practice addresses (Care Compare)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124072087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 HESPERIA RD",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451855",
            "telephone_number": "760-948-1454",
            "fax_number": "760-948-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15863 KASOTA RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923074507",
            "telephone_number": "760-948-1454",
            "fax_number": "760-948-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRUCE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0050902",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevork Iskenderian, M.D.
• Sergio Islas
• Shurouk I Ismail, MD
• Amanda Leigh Jackson
• Andre Nakromba Jackson, MFTI
• Daysia Jackson
• Fredrick Jackson
• Jessica Jackson
• Terri Jackson, RN
• Christopher Louis Jaco, PA-C

• All providers in Apple Valley, CA
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.