Individual
MS. ETSUKO TAKEHANA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1600 SAN FERNANDO RD, SAN FERNANDO, CA 91340-3115
(818) 365-8086
Mailing address
1600 SAN FERNANDO RD, SAN FERNANDO, CA 91340-3115
(714) 853-3321
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95010027
CA
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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