Active NPI
La Porsche Michelle Jackson, M.ED/CI
- Rehabilitation Practitioner
- Riverside, CA
National Provider Identifier
1760274831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 10672 Pendleton St
Riverside, CA 92505-1740 - Phone
- (310) 912-5168
- NPI assigned
- May 22, 2025
- Sex
- Female
- Sole proprietor
- Yes
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
10672 Pendleton St
Riverside, CA 92505-1740
Mailing address
22890 Pahute Dr
Moreno Valley, CA 92553-6427
Phone (310) 912-5168
Other practice location 1
2201 E 4th St
Santa Ana, CA 92705-3804
Phone (310) 912-5168
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1760274831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22890 PAHUTE DR",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925536427",
"telephone_number": "310-912-5168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10672 PENDLETON ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925051740",
"telephone_number": "310-912-5168"
}
],
"practiceLocations": [
{
"address_1": "2201 E 4th St",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927053804",
"country_code": "US",
"telephone_number": "310-912-5168",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "LA PORSCHE",
"middle_name": "MICHELLE",
"credential": "M.ED/CI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-22",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.