Lisa Jacobs, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A149687 Issued in CA

Practice address

17100 Euclid Street, Picu
Fountain Valley, CA 92708

Phone

(714) 966-7253

Fax

(714) 966-3354

NPI assigned

Mar 27, 2015

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cottage Clinical Associates

  dba Cottage Children's Medical Group

  • Multi-Specialty Clinic/Center
  • Santa Barbara, CA
  • NPI 1235790544

  Pediatrics

  Medicare reassignment NPD
• Cottage Medical Foundation

  dba Cottage Medical Group

  • Clinic/Center
  • Santa Barbara, CA
  • NPI 1770352130
  Medicare reassignment NPD
• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD
• County of Los Angeles Auditor Controller

  dba Los Angeles County Olive View-UCLA Medical Center

  • General Acute Care Hospital
  • Sylmar, CA
  • NPI 1134159320
  NPD
• South Counties Pediatric Critical Care Medical Group

  • Pediatric Critical Care Medicine Physician
  • Fountain Valley, CA
  • NPI 1609853688
  NPD (past)

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1376937367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLAZA, B711",
            "address_2": "RRUMC",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900957419",
            "telephone_number": "310-267-9129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 EUCLID STREET, PICU",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-966-7253",
            "fax_number": "714-966-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A149687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivy Cottages III
• Nwanyieze Iyalomhe
• Jack F Jacoub MD Inc
• Joshua Robert Jackson, APRN
• Kathlyn Tan Jackson, MT
• Elizabeth M Jacobsen
• John R Jacomo, MD
• Jack F Jacoub, M.D.
• Rosemary Rupali Jadia, D.P.M.
• Esther Jahng, RDH

• Pediatrics Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.