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General NPI Number Information
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NPI Number | 1235547530
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Entity Type | Individual
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Provider Name | DEBORAH JACOBS P.T.
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Gender | Female
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 07/30/2014
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Provider Practice Location Address
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Address Line | 7200 REDWOOD BLVD
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City | NOVATO
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State | CA
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Zip | 94945-3250
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Country | US
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Telephone | 415-566-5488
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Fax |
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Provider Business Mailing Address
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Address Line | 16934 HOFACKER LN
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City | LOWER LAKE
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State | CA
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Zip | 95457-9183
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Country | US
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Telephone | 707-485-4413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 16355
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License Number State | CA
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