Individual
KATHERINE LEE JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP
Contact information
Practice address
455 S MAIN ST, ORANGE, CA 92868-3835
(713) 532-8704
Mailing address
1520 E ADAMS AVE, ORANGE, CA 92867-5909
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
653944
CA
Other
Enumeration date
05/28/2007
Last updated
07/08/2007
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