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General NPI Number Information
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NPI Number | 1811100134
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Entity Type | Individual
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Provider Name | PHILIPPA JACOBS N.P.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 14623 HAWTHORNE BLVD SUITE 300
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City | LAWNDALE
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State | CA
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Zip | 90260-1581
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Country | US
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Telephone | 213-284-3121
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Fax | 213-284-3369
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Provider Business Mailing Address
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Address Line | 2522 31ST ST
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City | SANTA MONICA
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State | CA
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Zip | 90405-3011
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Country | US
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Telephone | 310-450-0328
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 118699
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License Number State | CA
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