Patricia Jacobo, MS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT130677 Issued in CA

Practice address

6931 Van Nuys Blvd Ste 102
Van Nuys, CA 91405-3980

Phone

(818) 376-0134

NPI assigned

Mar 6, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1336279033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 RAYEN ST",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913435117",
            "telephone_number": "818-892-3423",
            "fax_number": "818-893-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6931 VAN NUYS BLVD STE 102",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053980",
            "telephone_number": "818-376-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBO",
        "first_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF91614",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "62766",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT130677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "95-2633765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryanna Jackson
• Chloe Jackson
• Jaylynn Jackson
• Kammie Jackson
• Staci Jackson, BCBA
• Irving Lionel Jacobs, D.C.
• Russell Jacobs Jr.
• Marwa Jad, ASW
• Jade T. Ong DDS. Inc.
• Jaems Lim D D S Prof Corp

• Marriage & Family Therapist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.