Joseph Daniel Jacobs, PHD, BCBA-D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY33549 Issued in CA

Practice address

12304 Santa Monica Blvd Ste 315
Los Angeles, CA 90025-2551

Phone

(310) 957-5126

Fax

(323) 272-4076

NPI assigned

Mar 5, 2015

Last updated

Mar 26, 2023By the provider in NPPES

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Jacobs Psychological Services, PC

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1730889817

  Behavior Analyst

  Medicare reassignment NPD Authorized official
• Jacobs Neurobehavioral Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1871446070
  NPD Authorized official
• Behavioral Interventions for Children, LLC

  • Early Intervention Provider Agency
  • Encino, CA
  • NPI 1992190565
  NPD (past) Authorized official

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679788800000",
    "number": "1629461314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16350 VENTURA BLVD STE D147",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914365300",
            "telephone_number": "310-957-5126",
            "fax_number": "818-654-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12304 SANTA MONICA BLVD STE 315",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252551",
            "telephone_number": "310-957-5126",
            "fax_number": "323-272-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JOSEPH",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PHD, BCBA-D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-05",
        "last_updated": "2023-03-26",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY33549",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR8889095",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iyanna Jacobs
• Jeffrey D. Jacobs, D.C.
• Joanna Murstein Jacobs, PSY.D.
• John Yaghoubieh Jacobs, O.D.
• Jonathan Patrick Jacobs, M.D.
• Karen Jacobs, PA-C
• Lynne Jacobs, PH.D.
• Marilyn Susan Jacobs, PH.D.
• Megan S Jacobs, MD
• Melissa Jacobs, PH.D.

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.