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

Gracie Ellen Jackson, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1255956314

Gracie Ellen Jackson, PMHNP-BC is a Nurse Practitioner in South Pasadena, California. Qualified in 2020, 6 years ago. Practices with Pacific Clinics, a 74-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

625 Fair Oaks Ave Ste 300
South Pasadena, CA 91030-5805
Phone: (626) 441-4221
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence NP95015149 (CA)

Record details

NPI number1255956314
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedJune 14, 2020
Last updated in NPPESMarch 11, 2024
Certification dateMarch 11, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Pacific Clinics — 74 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in South Pasadena