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Individual

DR. SUSAN M. JACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1101 DOVE ST, SUITE 160, NEWPORT BEACH, CA 92660-2839
(949) 851-5022
(949) 851-5123
Mailing address
1101 DOVE ST, SUITE 160, NEWPORT BEACH, CA 92660-2839
(949) 851-5022
(949) 851-5123

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MFT25105
CA

Other

Enumeration date
07/31/2006
Last updated
07/08/2007
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