Individual
DR. KRISTIN KELI JACOBSON PURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, ABPP
Contact information
Practice address
2185 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 839-6282
Mailing address
2185 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 839-6282
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY26477
CA
103T00000X
Psychologist
PSY26477
CA
Other
Enumeration date
09/03/2009
Last updated
10/21/2022
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