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Keelan Jackson
NPI 1790449882 · Independent Duty Corpsman · San Diego, CA
Keelan Jackson is a Independent Duty Corpsman provider in San Diego, CA (NPI 1790449882).
Provider details
- NPI number
- 1790449882
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Student, Health Care
Profile Score
Established profile(55/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
83% 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
34899 Bob Wilson Dr
San Diego, CA 92134-0001
Phone: (619) 532-6400
Approximate (ZIP-level) locationGet directions
Mailing address
34101 Farenholt Ave Bldg 14
San Diego, CA 92134-7000
Registry dates
- Enumerated
- 2021-10-26
- Last updated
- 2022-06-15
- Certified
- 2022-06-15
Frequently asked questions
- What is Keelan Jackson's NPI number?
- Keelan Jackson's National Provider Identifier (NPI) is 1790449882, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Keelan Jackson's specialty?
- Keelan Jackson is listed in the NPPES registry with a primary specialty of Independent Duty Corpsman (Other Service Providers).
- Where is Keelan Jackson located?
- Keelan Jackson's practice location on file with NPPES is 34899 Bob Wilson Dr, San Diego, CA 92134-0001.
- What is Keelan Jackson's phone number?
- The practice phone number listed in the NPPES registry for Keelan Jackson is (619) 532-6400.
- Is Keelan Jackson's NPI active?
- Yes — Keelan Jackson's NPI (1790449882) is active in the NPPES registry as of the last update on 2022-06-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.