Healthcare Provider Details

I. General information

NPI: 1346539814
Provider Name (Legal Business Name): JACOB MARTIN STUEBS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JACOB MARTIN DC

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1522 STATE ST # A
SANTA BARBARA CA
93101-2514
US

IV. Provider business mailing address

1522 STATE ST # A
SANTA BARBARA CA
93101-2514
US

V. Phone/Fax

Practice location:
  • Phone: 805-665-3835
  • Fax: 805-617-0228
Mailing address:
  • Phone: 805-665-3835
  • Fax: 805-617-0228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number31824
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number31824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: