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General NPI Number Information
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NPI Number | 1316718711
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Entity Type | Organization
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Legal Business Name | INSIDE OUT PSYCHOLOGY INC
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 800 POLLARD RD STE B201
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City | LOS GATOS
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State | CA
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Zip | 95032-1429
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Country | US
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Telephone | 650-429-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 800 POLLARD RD STE B201
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City | LOS GATOS
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State | CA
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Zip | 95032-1429
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Country | US
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Telephone | 650-429-8787
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEANNE JAKOB
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Credential | PHD
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Telephone | 650-429-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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