Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jerrick Thacker, MSNAPRNFNP-C

Individual provider Nurse Practitioner · NPI 1275275307

Mr. Jerrick Thacker, MSNAPRNFNP-C is a Nurse Practitioner in Victorville, California. Qualified in 2021, 5 years ago. Practices with Ramin Ashtiani, MD a Professional Corporation, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2022
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Practice location Address checks out

13024 Hesperia Rd
Victorville, CA 92395-8302
Phone: (760) 241-3547
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8999 Sagebrush St, Apple Valley, CA 92308-8660 — (760) 646-7001

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95020352 (CA)

Record details

NPI number1275275307
Entity typeIndividual (Type 1)
GenderMale
Credentials MSNAPRNFNP-C
Sole proprietorYes
NPI enumeratedApril 9, 2022
Last updated in NPPESApril 25, 2022
Certification dateApril 25, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ramin Ashtiani, Md A Professional Corporation — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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