Individual
DR. JACOB WILLIAM JORGENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
154 BLACK POWDER CIR, FOLSOM, CA 95630-3415
(916) 804-1155
Mailing address
154 BLACK POWDER CIR, FOLSOM, CA 95630-3415
(916) 804-1155
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
135292
NY
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
135292
NY
Other
Enumeration date
03/22/2020
Last updated
02/03/2023
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