Individual
HOLLY JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
893 PATRIOT DR STE A, MOORPARK, CA 93021-3357
(805) 531-1000
(805) 531-1100
Mailing address
16353 BARNESTON ST, GRANADA HILLS, CA 91344-3017
(818) 913-2075
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
547154
CA
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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