Individual
JAN JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6055 MERIDIAN AVE STE 110, SAN JOSE, CA 95120-2700
(408) 927-0871
(408) 927-0891
Mailing address
6055 MERIDIAN AVE STE 110, SAN JOSE, CA 95120-2700
(408) 927-0871
(408) 927-0891
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3894831
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3894831
CA OT LICENSE
CA
Enumeration date
12/05/2006
Last updated
07/08/2007
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