Wendy Rebecca Jacobsen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

AMFT108464 Issued in CA

Practice address

375 Cambridge Ave
Palo Alto, CA 94306-1613

Phone

(650) 326-6576

NPI assigned

Sep 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1174007306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 COLLEGE AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 CAMBRIDGE AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061613",
            "telephone_number": "650-326-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "WENDY",
        "middle_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT108464",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Yulin Jacobs, AUD
• Matthew Adam Jacobs, DO
• Zachary Morris Jacobs
• Bailee Ann Jacobsen, DO
• Kayla May Jacobsen
• Christine Catherine Jacobson, MD
• Dane Robert Jacobson, MD
• Gohar Jaffer
• Justin Charles Jagodinsky
• Madina Jahed, MD

• Mental Health Counselor in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.