NPI Portal NPI Lookup & Verification

Mr. Bruce L Jackson, P.A.

Mr. Bruce L Jackson is a Medical Physician Assistant provider (Physician Assistant) practicing in Apple Valley, CA, registered in the NPPES registry with NPI 1124072087 since 2006. The credential PA stands for Physician Assistant.

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NPI 1124072087
Entity type Individual (Type 1)
Name Mr. Bruce L Jackson
Credential P.A.
Sex Male
Practice address 15863 KASOTA RD, Apple Valley, CA, 92307
Phone 7609481454
Fax 7609486100
Enumeration date 2006-05-22
Last updated in NPPES 2007-07-08

Taxonomy & licenses

Taxonomy code Specialty Primary License State
363AM0700X Medical Physician Assistant Primary PA14185 CA

PA — Physician Assistant: A licensed clinician who practices medicine in collaboration with physicians, trained in a graduate PA program. About the PA credential

Other identifiers

Identifier Type State Issuer
GR0050902 Medicaid CA
Copy-ready billing details
Provider: Bruce Jackson, P.A.
NPI: 1124072087
Taxonomy: 363AM0700X (Medical Physician Assistant)
Address: 15863 KASOTA RD, Apple Valley, CA, 92307

Other providers at this practice address

NPI Name Type Specialty Location
1154375053 Craig Mueller Individual Family Medicine Physician Apple Valley, CA
1114037942 Afp Drug Store Inc Organization Community/Retail Pharmacy Apple Valley, CA
1073647269 Desert Family Practice Associates Organization Family Medicine Physician Apple Valley, CA
1316204241 Afp Drugstore, Inc. Organization Community/Retail Pharmacy Apple Valley, CA
1699465732 Unicare Community Health Center, Inc. Organization Federally Qualified Health Center (FQHC) Apple Valley, CA

Verify this record

Cross-check NPI 1124072087 against the authoritative CMS record: view Mr. Bruce L Jackson on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where does Bruce Jackson practice?
The practice location on file with NPPES is in Apple Valley, CA. Providers can have multiple locations; NPPES lists the primary practice address.
What is the NPI number for Bruce Jackson?
The National Provider Identifier (NPI) for Bruce Jackson is 1124072087, a Type 1 (individual) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-07-08.