Individual
AVIVA LEORA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2325 CLEMENT AVE, ALAMEDA, CA 94501-7061
(510) 629-6300
(510) 865-1930
Mailing address
2325 CLEMENT AVE, ALAMEDA, CA 94501-7061
(510) 629-6300
(510) 865-1930
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8121
—
CA
Enumeration date
09/22/2009
Last updated
09/22/2009
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