Dajonae Jackson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017004 Issued in CA

Practice address

4621 Via Presidio
Camarillo, CA 93012-5836

Phone

(818) 618-2627

NPI assigned

Apr 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Nurse Practitioner

Practice roles

Locations

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.

• Los Angeles County Department of Public Health

  • Public Health & General Preventive Medicine Physician
  • Los Angeles, CA
  • NPI 1962109033
  Medicare reassignment NPD

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

{
    "created_epoch": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619222400000",
    "number": "1467034934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 VIA PRESIDIO",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125836",
            "telephone_number": "818-618-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 VIA PRESIDIO",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125836",
            "telephone_number": "818-618-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DAJONAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-24",
        "last_updated": "2021-04-24",
        "certification_date": "2021-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Island-Thomas
• Caitlin M Ismay
• Its Behavioral
• Paula Iwamoto-Schaap
• Jaa Home Care, Inc (Right at Home of Ventura County)
• Dez'Gillai Jackson
• Gary Jackson
• Wayne Harrison Jackson
• Brian Edwin Jacobson, PT
• Pia Shari Jacoby

• Family Nurse Practitioner in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.