Individual
CLARISSA JACOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11080 W WASHINGTON BLVD, CULVER CITY, CA 90232
(818) 747-4710
Mailing address
27066 HIDAWAY AVE UNIT 6, CANYON COUNTRY, CA 91351-4117
(818) 747-4710
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
03/28/2024
Last updated
05/13/2025
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