Individual
DR. BONNIE A JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3415 S. SEPULVEDA BLVD., SUITE 1100, LOS ANGELES, CA 90034
(323) 655-4056
(310) 390-8331
Mailing address
3415 S. SEPULVEDA BLVD., SUITE 1100, LOS ANGELES, CA 90034
(323) 655-4056
(310) 390-8331
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY13629
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY13629
LICENSE
CA
Enumeration date
08/21/2006
Last updated
02/24/2026
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