Individual
LUIS ALEJANDRO JACOBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
6385 PACIFIC AVE, STOCKTON, CA 95207-3713
(209) 477-9300
Mailing address
3616 JENNY LIND AVE, NORTH HIGHLANDS, CA 95660-5610
(916) 208-4144
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000053928
CA
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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