Individual provider Active NPI

Misty Jackson

  • Adult Companion
  • Carmichael, CA
National Provider Identifier
1912803503
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
3631 Walnut Ave
Carmichael, CA 95608-3051
Phone
(916) 628-8356
NPI assigned
Oct 19, 2026
Last updated
Oct 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X CA Primary

Addresses

Primary practice location

3631 Walnut Ave
Carmichael, CA 95608-3051

Mailing address

8712 Laguna Star Dr
Elk Grove, CA 95758-6316
Phone (916) 628-8356

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": "1792368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792368000000",
    "number": "1912803503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8712 LAGUNA STAR DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957586316",
            "telephone_number": "916-628-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 WALNUT AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956083051",
            "telephone_number": "916-628-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-19",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.