Individual
DR. CAROLYN FRANCES JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
4364 BONITA RD, BONITA, CA 91902-1421
(619) 254-2343
(619) 324-3879
Mailing address
4364 BONITA RD, BONITA, CA 91902-1421
(619) 254-2343
(619) 324-3879
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY15774
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP938A
MEDICARE PTAN
CA
Enumeration date
06/18/2006
Last updated
09/05/2024
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