Individual
SOPHIE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
(602) 521-3050
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11110
AZ
Other
Enumeration date
04/30/2024
Last updated
09/10/2025
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