Active NPI
Larita Ann Jackson
- Rehabilitation Practitioner
- Sacramento, CA
National Provider Identifier
1376668244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 2750 Sutterville Rd
Sacramento, CA 95820-1024 - Phone
- (916) 452-3981
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 19547 | CA | |
| Rehabilitation Practitioner | 225400000X | CA | Primary |
Addresses
Primary practice location
2750 Sutterville Rd
Sacramento, CA 95820-1024
Mailing address
2750 Sutterville Rd
Sacramento, CA 95820-1093
Phone (916) 452-3981
Other practice location 1
3321 Power Lnn Road ste 110
Sacramento, CA 95826
Phone (916) 247-7191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109108 | CA | MD | Dentist |
| 6562 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1376668244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2750 SUTTERVILLE RD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958201093",
"telephone_number": "916-452-3981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 SUTTERVILLE RD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958201024",
"telephone_number": "916-452-3981"
}
],
"practiceLocations": [
{
"address_1": "3321 Power Lnn Road ste 110",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "95826",
"country_code": "US",
"telephone_number": "916-247-7191",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "LARITA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "19547",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.