Individual provider Active NPI

Jacob Timothy Grisaffi, RN

  • Registered Nurse
  • Sacramento, CA
National Provider Identifier
1972463305
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95428119 Issued in CA
Practice address
2825 Capitol Ave
Sacramento, CA 95816-6039
Phone
(916) 887-0000
NPI assigned
Nov 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95428119 CA Primary

Addresses

Primary practice location

2825 Capitol Ave
Sacramento, CA 95816-6039

Mailing address

101 Lagomarsino Way
Sacramento, CA 95819-2335
Phone (916) 532-9637

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95428119CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1972463305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LAGOMARSINO WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958192335",
            "telephone_number": "916-532-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 CAPITOL AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166039",
            "telephone_number": "916-887-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISAFFI",
        "first_name": "JACOB",
        "middle_name": "TIMOTHY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95428119",
            "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 Nov 17, 2025; 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.