Vivian Jacobo

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

ATR-100217 Issued in AZ

Practice address

1 W Firestorm Way
Glendale, AZ 85306-3216

Phone

(602) 489-5300

NPI assigned

Jul 28, 2025

Last updated

Jul 28, 2025By the provider in NPPES

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

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": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1255214359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49128 PLUMA GRIS PL",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922365485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W FIRESTORM WAY",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063216",
            "telephone_number": "602-489-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBO",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "ATR-100217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Renee Jackson
• Tamarra Mesha Jackson, BT
• Venella Jackson
• Victoria L Jackson, MPT
• Rachel Thomas Jacob, NP-C
• Don Jacobs
• Marissa Jacobs, D.O.
• Tiana Jacobson
• Carrie Jacovini, PA C
• Jacqueline M Solomon D O P C

• Athletic Trainer in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Athletic Trainer in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.