| Joel Jackson, | |
|
4301 X Street, Sacramento, CA 95817 | |
| (419) 953-4775 | |
| Not Available |
| Full Name | Joel Jackson |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 1 Years |
| Location | 4301 X Street, Sacramento, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366281826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | APRN.CRNA.0021045 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of California Davis Medical Center | Sacramento, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Regents Of The Univ Of Ca | 3375456619 | 1468 |
| Entity Name | Regents Of The Univ Of Ca |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013906973 PECOS PAC ID: 3375456619 Enrollment ID: O20031111000892 |
| Mailing Address | Practice Location Address |
|---|---|
| Joel Jackson, 4012 San Marino St, Dayton, OH 45440 Ph: (419) 953-4775 | Joel Jackson, 4301 X Street, Sacramento, CA 95817 Ph: (419) 953-4775 |
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