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NPI Code Detail

MEDICARE: DEMETRIUS JACOBS

MEDICARE: DEMETRIUS JACOBS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1477405892
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEMETRIUS JACOBS
Provider Business Mailing Address
First Line : 7444 GARDEN MEADOW LN
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-2984
Country : US
Telephone Number : 916-478-1353
Fax Number :
Provider Business Practice Location Address
First Line : 584 KENTUCKY AVE
Second Line :
City : WOODLAND
State : CA
Zip : 95695-2779
Country : US
Telephone Number : 530-661-3213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “ DEMETRIUS JACOBS ” Practice Location

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