Individual
DR. ELLEN RACHAEL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7734 HERSCHEL AVE, STE E, LA JOLLA, CA 92037-4433
(858) 459-6341
Mailing address
643 FERN GLN, LA JOLLA, CA 92037-5419
(858) 459-5132
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY11462
CA
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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