MEDICARE: JESSICA JACOBSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	PSB94026672	CA

General Provider Information

NPI Number	:	1043069339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA JACOBSON

Provider Business Mailing Address
First Line	:	28 CORTEZ RD
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94062-3246
Country	:	US
Telephone Number	:	650-247-9595
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 THE ALAMEDA STE 610-630
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1404
Country	:	US
Telephone Number	:	408-475-1665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2024
Last Update Date	:	05/17/2024

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Directions to “ JESSICA JACOBSON ” Practice Location

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