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General NPI Number Information
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NPI Number | 1790612497
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Entity Type | Organization
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Legal Business Name | LUCAS JACOBSEN PSYCHIATRIC NURSING A PROFESSIONAL NURSING CORPORATION
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 462 STEVENS AVE STE 206
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City | SOLANA BEACH
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State | CA
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Zip | 92075-2065
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Country | US
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Telephone | 858-786-0875
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Fax |
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Provider Business Mailing Address
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Address Line | 462 STEVENS AVE STE 206
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City | SOLANA BEACH
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State | CA
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Zip | 92075-2065
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | LUCAS JACOBSEN
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Credential | PMHNP-C
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Telephone | 858-786-0875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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