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Individual
DR. RICHARD SAMUEL JACOBSON
Active
Individual
DR. RICHARD SAMUEL JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M,D,
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
G15588
CA
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
G15588
CA
2084P0800X
Psychiatry Physician
Primary
G15588
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G155880
—
CA
01
—
G15588
STATE LICENSE NUM
CA
Enumeration date
02/12/2007
Last updated
08/21/2012
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