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General NPI Number Information
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NPI Number | 1497039259
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Entity Type | Individual
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Provider Name | JACOB SCHMIDT PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 1540 MARKET ST STE 340
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-6048
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Country | US
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Telephone | 415-397-6622
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 MARKET ST STE 340
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-6048
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Country | US
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Telephone | 415-397-6622
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY25480
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License Number State | CA
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