Individual provider Active NPI

Patience Jackson, RN

  • Registered Nurse
  • Cerritos, CA
National Provider Identifier
1477413615
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
758606 Issued in CA
Practice address
19112 Gridley Rd Ste 200
Cerritos, CA 90703-6614
Phone
(562) 740-6661
Fax
(562) 546-1409
NPI assigned
Nov 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 758606 CA Primary

Addresses

Primary practice location

19112 Gridley Rd Ste 200
Cerritos, CA 90703-6614

Mailing address

19112 Gridley Rd Ste 200
Cerritos, CA 90703-6614
Phone (562) 740-6661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
758606CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Care Home Health Agency Inc. CurrentSince Nov 18, 2025 Accepting new patients

Locations

19112 Gridley Rd
Ste 200
Cerritos, CA 90703
Phone (562) 403-0306

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1477413615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19112 GRIDLEY RD STE 200",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036614",
            "telephone_number": "562-740-6661",
            "fax_number": "562-546-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19112 GRIDLEY RD STE 200",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036614",
            "telephone_number": "562-740-6661",
            "fax_number": "562-546-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "PATIENCE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "758606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.