Individual
JULIENNE RAQUEL JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4650 W SUNSET BLVD, MS# 82, LOS ANGELES, CA 90027-6062
(323) 669-2471
(323) 667-2019
Mailing address
3250 WILSHIRE BLVD STE 1101, LOS ANGELES, CA 90010-1513
(323) 361-2336
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A68305
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A683050
—
CA
01
—
00A683050 N66
CAL OPTIMA'
CA
Enumeration date
10/03/2006
Last updated
12/16/2024
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