Individual
AMANDA KAY JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 W WASHINGTON AVE, ESCONDIDO, CA 92025-1643
(760) 489-6380
Mailing address
550 W WASHINGTON AVE, ESCONDIDO, CA 92025-1643
(760) 489-6380
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Enumeration date
09/21/2021
Last updated
11/07/2023
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