IndividualActive
Carol Jackson, CRNA
NPI 1104993963 · Certified Registered Nurse Anesthetist · Los Angeles, CA
Provider details
- NPI number
- 1104993963
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- License
- NA359 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4760 W Sunset Blvd
Los Angeles, CA 90027-6063
Phone: (323) 783-4011
Street-level locationGet directions
Mailing address
393 E Walnut St
Pasadena, CA 91188-0001
Registry dates
- Enumerated
- 2006-11-29
- Last updated
- 2007-11-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.