Individual
JACOB ALEXANDER VIRTUSIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
170 S SPRUCE AVE STE 200, SOUTH SAN FRANCISCO, CA 94080-4557
(650) 517-8220
Mailing address
170 S SPRUCE AVE STE 200, SOUTH SAN FRANCISCO, CA 94080-4557
(415) 725-0755
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
163W00000X
Registered Nurse
95296790
CA
363L00000X
Nurse Practitioner
Primary
95296790
CA
Other
Enumeration date
05/23/2019
Last updated
11/14/2023
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