Active NPI
Annika Graveline
- Rehabilitation Practitioner
- Jackson, CA
National Provider Identifier
1174435051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 601 Court St Ste 100
Jackson, CA 95642-2162 - Phone
- (209) 257-1244
- NPI assigned
- Sep 17, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | CA | Primary |
Addresses
Primary practice location
601 Court St Ste 100
Jackson, CA 95642-2162
Mailing address
601 Court St Ste 100
Jackson, CA 95642-2162
Phone (209) 257-1244
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789603200000",
"number": "1174435051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 COURT ST STE 100",
"city": "JACKSON",
"state": "CA",
"postal_code": "956422162",
"telephone_number": "209-257-1244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 COURT ST STE 100",
"city": "JACKSON",
"state": "CA",
"postal_code": "956422162",
"telephone_number": "209-257-1244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVELINE",
"first_name": "ANNIKA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-09-17",
"last_updated": "2026-09-17",
"certification_date": "2026-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.