Tonya Annette Jackson, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

740919 Issued in CA

Practice address

2101 Courage Dr
Fairfield, CA 94533-6717

Phone

(707) 784-2080

NPI assigned

Mar 29, 2021

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

Electronic endpoints 1

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1679151187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 HAFLINGER DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945343802",
            "telephone_number": "707-416-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-784-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TONYA",
        "middle_name": "ANNETTE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "740919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tajackson@solanocounty.com",
            "affiliation": "N",
            "endpointDescription": "employee email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Exchange",
            "address_1": "2101 Courage Dr",
            "city": "Fairfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945336717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyle Lamet Jackson
• Latasha Jackson
• Lisa Ann Jackson
• Naomi Jackson
• Scott Aaron Jackson, M.S., CCC-SLP
• Zariah Jackson
• Sneha Susan Jacob
• Julyana Denae Jacobs
• Tiana Jacobs
• Lisa Ann Jacobson

• Registered Nurse in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.