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Individual

DR. LISA JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
825 OAK GROVE AVE STE D202, MENLO PARK, CA 94025-4427
(650) 223-5514
(415) 413-2335
Mailing address
50 CHURCH ST STE 112, MONTCLAIR, NJ 07042-2761
(650) 223-5514
(415) 413-2335

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
25MA11471200
NJ
2084P0804X
Child & Adolescent Psychiatry Physician
316492-01
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A148928
CA

Other

Enumeration date
04/07/2014
Last updated
09/22/2023
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