Lauren Nicole Jackson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64902 Issued in CA

Practice address

30448 Rancho Viejo Rd Ste 150
San Juan Capistrano, CA 92675-1572

Phone

(949) 489-0773

NPI assigned

Jun 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lauren.jackson.1@21138.direct.athenahealth.com

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1912639873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30448 RANCHO VIEJO RD STE 150",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30448 RANCHO VIEJO RD STE 150",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751572",
            "telephone_number": "949-489-0773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2219 W Euless Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Euless",
            "state": "TX",
            "postal_code": "760406679",
            "country_code": "US",
            "telephone_number": "866-971-7393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19625",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J.F.Shea Therapeutic Riding Center
• J&J Healing Journeys Licensed Professional Clinical Counselor Inc
• Riley Jacko, NP-C
• Emily Ann Jackson, DDS
• Karen Sue Jackson, RN BSN
• Albrik Patrick Jacobi
• Jacques J Palmer M D Inc
• Jamc&C LLC (Senior Helpers of Dana Point)
• Jamc&C LLC (Senior Helpers of Dana Point)
• Nancy James, D.C.

• Physician Assistant in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; 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.