Kenneth Walter Jacobs Jr., PHD

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-36125 Issued in CA

Practice address

795 Folsom St
San Francisco, CA 94107-1243

Phone

(855) 832-6727

NPI assigned

Apr 5, 2018

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599350400000",
    "number": "1699271718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462",
            "telephone_number": "855-832-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 FOLSOM ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941071243",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "KENNETH",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2020-09-06",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-19-36125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel K Jacobs
• Donaldj R Jacobs Jr.
• Gabrielle Jacobs, N.P.
• Gary Jacobs
• Joyce Elizabeth Jacobs
• Laurie Jacobs, MFT
• Leah Jacobs
• Lois Jacobs, CRNA
• Marc H. Jacobs
• Marcia E. Jacobs, F.N.P. - B.C.

• Behavior Analyst in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.