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NPI Code Detail

MEDICARE: DR. ALAN JACOBSON PSY.D.

MEDICARE: DR. ALAN JACOBSON PSY.D.
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
1103TC0700XClinical Psychologist7110MA

General Provider Information

NPI Number : 1427065218
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALAN JACOBSON PSY.D.
Provider Business Mailing Address
First Line : 66 FAIRVIEW ST
Second Line :
City : WESTWOOD
State : MA
Zip : 02090-1238
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15 COTTAGE ST
Second Line : SUITE 5-F
City : NORWOOD
State : MA
Zip : 02062-2153
Country : US
Telephone Number : 617-680-5488
Fax Number : 781-320-1994
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 02/25/2011

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