Kyla Jackson
Student in an Organized Health Care Education/Training Program in Montclair, CA. Individual provider (NPI-1).
NPI number1932085263
StatusActive
Last updated in NPPESAug 13, 2025
Details
- NPI
- 1932085263
- Entity type
- Individual (NPI-1)
- Name
- Kyla Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 13, 2025
- Certification date
- Aug 13, 2025
- Last updated
- Aug 13, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
4825 Cypress St Unit 210Montclair, CA 91763-1451
Phone 707-293-6681
Mailing address
4825 Cypress St Unit 210Montclair, CA 91763-1451
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 47 Student in an Organized Health Care Education/Training Program providers in Montclair · All 1,614 providers in Montclair
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