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

MS. Shanna Shaneen Jackson, NP

Individual provider Registered Nurse · NPI 1710506472

MS. Shanna Shaneen Jackson, NP is a Nurse Practitioner in Moreno Valley, California. Qualified in 2021, 5 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2020
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

24060 Fir Ave Ste A
Moreno Valley, CA 92553-2895
Phone: (951) 247-8005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12815 Heacock St, Moreno Valley, CA 92553-3116 — (951) 601-6149

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95013739 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 755399 (CA)

Record details

NPI number1710506472
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedApril 13, 2020
Last updated in NPPESApril 26, 2022
Certification dateFebruary 15, 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 Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Moreno Valley