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

Kathlyn Tan Jackson, MT

Individual provider Massage Therapist · NPI 1205421526

Kathlyn Tan Jackson, MT is a Massage Therapist in Fountain Valley, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
What do these letters mean?
MT — Medical Technologist
Performs laboratory testing on clinical specimens.

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Practice location Address checks out

11770 Warner Ave Ste 123
Fountain Valley, CA 92708-2660
Phone: (714) 277-7169
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 39797 (CA)

Record details

NPI number1205421526
Entity typeIndividual (Type 1)
GenderFemale
Credentials MT
Sole proprietorYes
NPI enumeratedMarch 8, 2021
Last updated in NPPESMarch 8, 2021
Certification dateMarch 8, 2021

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