Active NPI
Stephanie Jacobs, PH.D.
- Psychologist
- Long Beach, CA
National Provider Identifier
1487985396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2135
- Practice address
- 1140 E Ocean Blvd Unit 124
Long Beach, CA 90802 - Phone
- (323) 326-4606
- NPI assigned
- Jan 18, 2010
- 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 | 2135 | KS | Primary |
Addresses
Primary practice location
1140 E Ocean Blvd Unit 124
Long Beach, CA 90802
Mailing address
1140 E Ocean Blvd Unit 124
Long Beach, CA 90802-5662
Phone (323) 326-4606
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2135 | KS | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1487985396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1140 E OCEAN BLVD UNIT 124",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908025662",
"telephone_number": "323-326-4606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 E OCEAN BLVD UNIT 124",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90802",
"telephone_number": "323-326-4606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-18",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "KS",
"license": "2135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.