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

Jackson Tea, MSN, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1477365997

Jackson Tea, MSN, PMHNP-BC is a Nurse Practitioner in Anaheim, California. Qualified in 2025, 1 year ago. Practices with Coast Medical P C, an 8-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2025
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

1720 W Ball Rd Ste 4C
Anaheim, CA 92804-5591
Phone: (714) 683-1472
Fax: (714) 683-1473
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 421 N Brookhurst St Ste 119, Anaheim, CA 92801-5618 — (714) 361-0898
  • 354 Uluniu St Ste 404, Kailua, HI 96734-2534 — (808) 215-3652

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95033550 (CA)

Record details

NPI number1477365997
Entity typeIndividual (Type 1)
GenderMale
Credentials MSN , PMHNP-BC
Sole proprietorYes
NPI enumeratedJanuary 22, 2025
Last updated in NPPESApril 15, 2025
Certification dateApril 15, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Coast Medical P C — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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