IndividualActive
Jerilyn Jackson, M.D.
NPI 1962446575 · Emergency Medicine Physician · Santa Rosa, CA
Provider details
- NPI number
- 1962446575
- Entity type
- Individual
- Primary specialty
- Emergency Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- G67649 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(95/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
1110 N Dutton Ave
Santa Rosa, CA 95401-4606
Phone: (707) 303-3600
Street-level locationGet directions
Mailing address
1772 Piner Rd
Santa Rosa, CA 95403-7401
Additional practice locations (1)
- 3569 Round Barn CirVista Family Health Center, Office GreenSanta Rosa, CA 95403-1757Phone: (707) 303-3600Fax: (707) 303-3609
Registry dates
- Enumerated
- 2006-06-15
- Last updated
- 2018-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.