Active NPI
Devin Jackson
- Physical Therapy Assistant
- Auburn, CA
National Provider Identifier
1669349841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 54165
- Practice address
- 11930 Heritage Oak PL
Auburn, CA 95603-2458 - Phone
- (530) 887-8785
- NPI assigned
- Oct 21, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 54165 | CA | Primary |
Addresses
Primary practice location
11930 Heritage Oak PL
Auburn, CA 95603-2458
Mailing address
7333 Auburn Oaks CT Apt 7
Citrus Heights, CA 95621-8408
Phone (310) 923-3993
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54165 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761004800000",
"number": "1669349841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7333 AUBURN OAKS CT APT 7",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956218408",
"telephone_number": "310-923-3993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11930 HERITAGE OAK PL",
"city": "AUBURN",
"state": "CA",
"postal_code": "956032458",
"telephone_number": "530-887-8785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "DEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-21",
"last_updated": "2025-10-21",
"certification_date": "2025-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "54165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.