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General NPI Number Information
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NPI Number | 1699449645
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Entity Type | Individual
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Provider Name | LINDA JACOBO
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Gender | Female
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 6529 RIVERSIDE AVE
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City | RIVERSIDE
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State | CA
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Zip | 92506-3122
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Country | US
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Telephone | 951-228-2832
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Fax | 714-333-4535
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Provider Business Mailing Address
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Address Line | PO BOX 53413
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City | IRVINE
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State | CA
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Zip | 92619-3413
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Country | US
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Telephone | 951-228-2832
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Fax | 714-333-4535
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-66034
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License Number State | CA
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