Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Cedric Jackson, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1588557219

Cedric Jackson, FNP-BC is a Nurse Practitioner in San Diego, California. Qualified in 2021, 5 years ago. Practices with Wound Management Specialists LLC, a 158-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
5
Licensed in
TX
In the registry since
2025
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

404 Camino Del Rio S Ste 102
San Diego, CA 92108-3586
Phone: (800) 316-6314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1208385 (TX)

Record details

NPI number1588557219
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedJune 2, 2025
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Wound Management Specialists Llc — 158 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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