Active NPI
Cindy Jacobo
- Behavior Technician
- Dalton, GA
National Provider Identifier
1063141034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB726159
- Practice address
- 404 W Matilda St
Dalton, GA 30720-8839 - Phone
- (678) 216-5860
- NPI assigned
- Jun 6, 2022
- Last updated
- Jun 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB726159 | GA | Primary |
Addresses
Primary practice location
404 W Matilda St
Dalton, GA 30720-8839
Mailing address
404 W Matilda St
Dalton, GA 30720-8839
Phone (678) 216-5860
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | cjacobo@teampbs.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB726159 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1063141034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 W MATILDA ST",
"city": "DALTON",
"state": "GA",
"postal_code": "307208839",
"telephone_number": "678-216-5860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 W MATILDA ST",
"city": "DALTON",
"state": "GA",
"postal_code": "307208839",
"telephone_number": "678-216-5860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBO",
"first_name": "CINDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-06",
"last_updated": "2022-06-06",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "BACB726159",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "cjacobo@teampbs.com",
"affiliation": "N",
"endpointDescription": "cjacobo@teampbs.com",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "cjacobo@teampbs.com",
"address_1": "404 W Matilda St",
"city": "Dalton",
"state": "GA",
"country_code": "US",
"postal_code": "307208839",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dalton, GA
- Ahmed Ayman Alaaeldin Ismail, MBBCH
- Stephanie Jacinto Orta
- Jacob Jackson
- Joanie Jackson, FNP
- Michael Walker Jackson, MS, M.DIV.,NCC, LPC
- Tomislav Hrvoje Jagatic, MD
- Dennis Justin Jarvis, TH.D., LMFT
- JD Medical Services Inc (Griffin Medical Services)
- JD Sleep Diagnostics LLC
- Jeffrey a. Houston DMD and John P. Robison DMD, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.