Healthcare Provider Details

I. General information

NPI: 1215110119
Provider Name (Legal Business Name): NAOMI JACOBS-EL DPT, LMT, RYT, CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2007
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902A LINCOLN BLVD # 108
SANTA MONICA CA
90405-1315
US

IV. Provider business mailing address

1902A LINCOLN BLVD # 108
SANTA MONICA CA
90405-1315
US

V. Phone/Fax

Practice location:
  • Phone: 256-653-8280
  • Fax:
Mailing address:
  • Phone: 256-653-8280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number2305
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: