Individual
MRS. ALISSA MARIE JACOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACSW
Contact information
Practice address
301 VICTORIA ST, COSTA MESA, CA 92627-1995
(949) 642-2734
Mailing address
301 VICTORIA ST, COSTA MESA, CA 92627-1995
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
110674
CA
Other
Enumeration date
09/30/2022
Last updated
10/12/2022
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