Individual provider · Type 1 NPI

Ryan Leland Jackson

Rehabilitation Practitioner · San Jose, CA

NPI number 1891665964 Active

Practice location

1302 N 4th St
San Jose, CA 95112-4713

Specialties and licenses

TaxonomyCodeLicense
Rehabilitation Practitioner Primary 225400000XE205069 (CA)

Rehabilitation Practitioner: A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

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About NPI 1891665964

Ryan Leland Jackson's National Provider Identifier is 1891665964, issued on Nov 5, 2025. The primary taxonomy on file is Rehabilitation Practitioner (225400000X), and the practice location is in San Jose, CA. The record was last updated on Nov 5, 2025.