Danielle Leenora Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA21525 Issued in CA

Practice address

1450 Fruitvale Ave
Oakland, CA 94601-2313

Phone

(510) 535-4110

NPI assigned

Jul 1, 2009

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

Other names 1

• Ms. Danielle Leenora King Former name

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• La Clinica de la Raza Inc

  dba La Clinica Monument

  • Federally Qualified Health Center (FQHC)
  • Concord, CA
  • NPI 1538181482
  Medicare reassignment Care Compare group
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  Medicare reassignment
• La Clinica de la Raza Inc

  dba La Clinica Dental at Children's Hospital Oakland

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1346262292
  NPD
• La Clinica de la Raza, Inc.

  dba Casa Del Sol

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1174639116
  NPD
• Contee Emergency Physicians

  • Emergency Medicine Physician
  • Laurel, MD
  • NPI 1710936398

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1770711459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012313",
            "telephone_number": "510-535-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012313",
            "telephone_number": "510-535-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DANIELLE",
        "middle_name": "LEENORA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "KING",
            "middle_name": "LEENORA",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aujanae Jackson
• Bahati Jackson
• Camille Jackson, M.D.
• Carolyn Renee Jackson
• Chloe Avonn Jackson
• Darvale Lavon Jackson
• Deangelo Raymon Jackson, M.S, AMFT
• Deshawn R Jackson
• Dimitria Elise Jackson
• Edward Jackson

• Physician Assistant in Oakland, CA
• Providers in Oakland, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.