Carrie Jackson, REGISTERED NURSE

Primary specialty

Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X

License

95085929 Issued in CA

Practice address

1469 Humboldt Rd
Suite 200
Chico, CA 95928-9203

Phone

(530) 891-1917

Fax

(530) 893-9347

NPI assigned

May 24, 2016

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1619324217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 ETHAN WAY",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1469 HUMBOLDT RD",
            "address_2": "SUITE 200",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959289203",
            "telephone_number": "530-891-1917",
            "fax_number": "530-893-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CARRIE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "95085929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ja&J Abejo-Woodbury Inc.
• Kimberly Lynn Jablonowski
• James Kyle Jack, PA-C
• Rose Marie Jack, RN
• Carol Ann Jackson, LVN
• Clifton Grant Jackson
• Jessica Jackson
• Lauren Alethea Jackson, M.S.
• Mark Alan Jackson, PA
• Sheri Jacobs, LMFT

• Ambulatory Women's Health Care Registered Nurse in Chico, CA
• Providers in Chico, CA by specialty
• Ambulatory Women's Health Care Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.