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

Jessie Wackerman

Individual provider Adult Health Nurse Practitioner · NPI 1053085076

Jessie Wackerman is an Adult Health Nurse Practitioner in Corona, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
Specialties on file
3

Practice location Address checks out

4101 Mount Cantara Cir
Corona, CA 92882-7942
Phone: (714) 267-9817
Show map & directions

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

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 95017895 (CA)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 95017895 (CA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 95017895 (CA)

Record details

NPI number1053085076
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 3, 2021
Last updated in NPPESAugust 3, 2021
Certification dateAugust 3, 2021
Mailing address4101 Mount Cantara Cir, Corona, CA 92882-7942

Other providers in Corona