Michael Simon Jacob, M.D., PH.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

133086 Issued in CA

Practice address

4150 Clement St
San Francisco, CA 94121-1563

Phone

(415) 221-4810

NPI assigned

Mar 23, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1363996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1184966582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 BUSH ST STE 131D",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095273",
            "telephone_number": "415-952-6018",
            "fax_number": "209-813-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211563",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Gough St Ste 115",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941026802",
            "country_code": "US",
            "telephone_number": "415-952-6018",
            "fax_number": "209-813-5559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 Bush St Ste 131D",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941095273",
            "country_code": "US",
            "telephone_number": "415-952-6018",
            "fax_number": "209-813-5559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "MICHAEL",
        "middle_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-23",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "133086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Jackson
• Anjali Jacob, MD, PHD
• Catherine Tait Jacob, LCSW
• Charles E. Jacob
• Jeric Manalang Jacob
• Alisa Marie Jacobo, MSW, LCSW
• Adam Jonathan Jacobs, D.C
• Cheryl Jacobs, L.M.F.T.
• Cheryl Wenell Jacobs, RN, ANP, MS
• Daniel K Jacobs

• Psychiatry Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.