Individual provider · Type 1 NPI

Mia Lanise Jackson, LVN

Licensed Vocational Nurse · Mission Viejo, CA

NPI number 1609598408 Active

Practice location

26921 Crown Valley Pkwy Ste 200
Mission Viejo, CA 92691-6501

Call (949) 334-8288 Map

Fax (949) 334-8294

Mailing address

34264 Chaparossa Dr
Lake Elsinore, CA 92532-2919

Specialties and licenses

TaxonomyCodeLicense
Licensed Vocational Nurse Primary 164X00000X689359 (CA)

Licensed Vocational Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. [An alternate term for licensed practical nurse arising from difference in occupational titles between states and post-high school training programs and institutions.] Requirements for education, experience, licensure, and job re…

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About NPI 1609598408

Mia Lanise Jackson, LVN's National Provider Identifier is 1609598408, issued on Sep 19, 2022. The primary taxonomy on file is Licensed Vocational Nurse (164X00000X), and the practice location is in Mission Viejo, CA. The record was last updated on Aug 11, 2026.