Lisa Jacobs, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A148928 Issued in CA

Practice address

825 Oak Grove Ave Ste D202
Menlo Park, CA 94025-4427

Phone

(650) 223-5514

Fax

(415) 413-2335

NPI assigned

Apr 7, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 25, 2026 through Feb 25, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1316366347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CHURCH ST STE 112",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422761",
            "telephone_number": "650-223-5514",
            "fax_number": "415-413-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 OAK GROVE AVE STE D202",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254427",
            "telephone_number": "650-223-5514",
            "fax_number": "415-413-2335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "291 Broadway Rm 710",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100071928",
            "country_code": "US",
            "telephone_number": "650-223-5514",
            "fax_number": "415-413-2335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Church St Ste 112",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070422761",
            "country_code": "US",
            "telephone_number": "650-223-5514",
            "fax_number": "415-413-2335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "316492-01",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A148928",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA11471200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vince Iwuji, RN
• Homeira Izadi, MD
• Robert Lionel Jack, M.D.
• Alison Moon Jackson, PSY.D.
• Jacqueline D.S. Jackson, PH.D.
• Matthew Townsend Jacobs
• Michael B. Jacobs, M.D.
• Sarah Naomi Jacobson, M.D.
• Shaheen Syeda Jafri, PT
• Jamie Paychev DDS Inc

• Child & Adolescent Psychiatry Physician in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.