Deborah M. Jacob, Psy.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00329800 Issued in NJ

Legal business name

DEBORAH M. JACOB, PSY.D., LLC

Practice address

1138 E Chestnut Ave
Building 6 Suite C
Vineland, NJ 08360-5053

Phone

(856) 691-1511

Fax

(856) 696-8517

NPI assigned

Feb 5, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Deborah M Jacob, PSY.D.

Title

Psychologist

Phone

(856) 691-1511

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1760660435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 E CHESTNUT AVE",
            "address_2": "BUILDING 6 SUITE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605053",
            "telephone_number": "856-691-1511",
            "fax_number": "856-696-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 E CHESTNUT AVE",
            "address_2": "BUILDING 6 SUITE C",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605053",
            "telephone_number": "856-691-1511",
            "fax_number": "856-696-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH M. JACOB, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "856-691-1511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00329800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "093679",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Davis, DO
• Briana Davy, MPAS
• Francine Davy, LPN
• Dca of Vineland LLC
• John Edward Deaver, MD
• Anthony Declerico, PHARM D
• Melissa Monica Degregorio, MCD, MCPD
• Edgardo Deleon, MD
• Ximena Delgadillo Ayala
• William J Deliberis, DPM

• Clinical Psychologist in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.