Jan Jacobsen, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3894831 Issued in CA

Practice address

6055 Meridian Ave Ste 110
San Jose, CA 95120-2700

Phone

(408) 927-0871

Fax

(408) 927-0891

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Broberg Physical Therapy

  • Physical Therapist
  • San Jose, CA
  • NPI 1528170669

  Occupational Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063570612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 MERIDIAN AVE STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202700",
            "telephone_number": "408-927-0871",
            "fax_number": "408-927-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 MERIDIAN AVE STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202700",
            "telephone_number": "408-927-0871",
            "fax_number": "408-927-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "JAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "3894831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA OT LICENSE",
            "identifier": "3894831",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Jacobs
• Linda Jacobs
• Ritch V. Jacobs, D.C.
• Sarah Marie Jacobs, MD
• Bruce E. Jacobsen, MD
• Jessica Jacobson
• Marie Therese Jacobson, L.AC.
• Michele Jacobson
• Nicholas Jacque
• Jacqueline B. Nguyen, D.D.S., a Professional Corporation

• Occupational Therapist in San Jose, CA
• Providers in San Jose, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.