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

Ryan Leland Jackson

Individual provider Rehabilitation Practitioner · NPI 1891665964

Ryan Leland Jackson is a Rehabilitation Practitioner in San Jose, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025

Practice location Address checks out

1302 N 4th St
San Jose, CA 95112-4713
Phone: (408) 379-3796
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X · Licence E205069 (CA)

Record details

NPI number1891665964
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 5, 2025
Last updated in NPPESNovember 5, 2025
Certification dateNovember 5, 2025
Mailing address1302 N 4th St, San Jose, CA 95112-4713

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