Active NPI
Clifford Loren Jacobson Jr., MFT
- Marriage & Family Therapist
- Chico, CA
National Provider Identifier
1356533285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT79264
- Practice address
- 578 Rio Lindo Ave
Chico, CA 95926-1800 - Phone
- (530) 894-5933
- Fax
- (530) 894-5791
- NPI assigned
- Aug 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT79264 | CA | Primary |
Addresses
Primary practice location
578 Rio Lindo Ave
Chico, CA 95926-1800
Mailing address
578 Rio Lindo Ave
Chico, CA 95926-1800
Phone (530) 894-5933
Other names 1
- Mr. Clifford Loren Jacobson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT79264 | CA | MD | Marriage & Family Therapist |
| 79264 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394582400000",
"number": "1356533285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "578 RIO LINDO AVE",
"city": "CHICO",
"state": "CA",
"postal_code": "959261800",
"telephone_number": "530-894-5933",
"fax_number": "530-894-5791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "578 RIO LINDO AVE",
"city": "CHICO",
"state": "CA",
"postal_code": "959261800",
"telephone_number": "530-894-5933",
"fax_number": "530-894-5791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "CLIFFORD",
"middle_name": "LOREN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-14",
"last_updated": "2014-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT79264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CLIFFORD",
"last_name": "JACOBSON",
"middle_name": "LOREN",
"prefix": "MR.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.