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

Keaysia Jackson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1063242766

Keaysia Jackson is a Student in an Organized Health Care Education/Training Program in Orange, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2024
Specialties on file
2

Practice location Address checks out

1201 W La Veta Ave
Orange, CA 92868-4203
Phone: (714) 509-8481
Show map & directions

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

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 94028476 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1063242766
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 6, 2024
Last updated in NPPESAugust 23, 2024
Certification dateAugust 23, 2024
Mailing address1201 W La Veta Ave, Orange, CA 92868-4203

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