Active NPI
Christian Jon Jacobs, LMFT
- Marriage & Family Therapist
- Elk Grove, CA
National Provider Identifier
1124484340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 136637
- Practice address
- 9563 Lakewind LN
Elk Grove, CA 95758-4658 - Phone
- (916) 802-2678
- NPI assigned
- Jan 4, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Marriage & Family Therapist | 106H00000X | 136637 | CA | Primary |
Addresses
Primary practice location
9563 Lakewind LN
Elk Grove, CA 95758-4658
Mailing address
9563 Lakewind LN
Elk Grove, CA 95758-4658
Phone (916) 802-2678
Other practice location 1
2101 Courage Dr
Fairfield, CA 94533-6717
Phone (707) 784-4900
Other names 1
- Mr. Christian Jon Jacobs
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 |
|---|---|---|---|
| 136637 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1124484340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9563 LAKEWIND LN",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957584658",
"telephone_number": "916-802-2678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9563 LAKEWIND LN",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957584658",
"telephone_number": "916-802-2678"
}
],
"practiceLocations": [
{
"address_1": "2101 Courage Dr",
"address_purpose": "LOCATION",
"city": "Fairfield",
"state": "CA",
"postal_code": "945336717",
"country_code": "US",
"telephone_number": "707-784-4900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOBS",
"first_name": "CHRISTIAN",
"middle_name": "JON",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-04",
"last_updated": "2023-01-03",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "136637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTIAN",
"last_name": "JACOBS",
"middle_name": "JON",
"prefix": "MR.",
"credential": "LMFT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.