Active NPI
Tanya Jacob, PHD
- Psychologist
- Pacific Palisades, CA
National Provider Identifier
1386875086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY23304
- Practice address
- 860 Via de la Paz Ste E3E
Pacific Palisades, CA 90272-3657 - Phone
- (310) 422-4132
- NPI assigned
- Jul 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY23304 | CA | Primary |
Addresses
Primary practice location
860 Via de la Paz Ste E3E
Pacific Palisades, CA 90272-3657
Mailing address
1329 Harvard St Apt 2
Santa Monica, CA 90404-2433
Phone (310) 422-4132
Other practice location 1
1145 Gayley Ave Ste 322
Los Angeles, CA 90024-3415
Phone (310) 208-7187 ext. 620
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY23304 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1386875086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1329 HARVARD ST APT 2",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042433",
"telephone_number": "310-422-4132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 VIA DE LA PAZ STE E3E",
"city": "PACIFIC PALISADES",
"state": "CA",
"postal_code": "902723657",
"telephone_number": "310-422-4132"
}
],
"practiceLocations": [
{
"address_1": "1145 Gayley Ave Ste 322",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900243415",
"country_code": "US",
"telephone_number": "310-208-7187 x620",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOB",
"first_name": "TANYA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-30",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY23304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pacific Palisades, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.