Jacob Allen Mitchell, CCP

Primary specialty

PerfusionistTaxonomy code 242T00000X

Practice address

9888 Genesee Ave
La Jolla, CA 92037-1205

Phone

(858) 834-1798

NPI assigned

Apr 9, 2025

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1306630736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4084 CRYSTAL DAWN LN UNIT 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225846",
            "telephone_number": "608-697-9321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 GENESEE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371205",
            "telephone_number": "858-834-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "JACOB",
        "middle_name": "ALLEN",
        "credential": "CCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Mirza, MD
• Michael Misel
• Mission Beach Holdings LLC (La Jolla Post-Acute)
• Brendon Cranfill Mitchell, MD
• Christine Marie Mitchell, ATC
• Jeffrey Alan Mitchell, P.T.
• Miyamoto and Phi Dental Corporation (La Jolla Del Sur Dental)
• Ellen A Miyashiro, DMD
• Hirotaka Miyashita, MD
• Mari Ayako Miyoshi

• Perfusionist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Perfusionist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.