Diana P. Jacobs, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00002516 Issued in WA

Practice address

960 Harris Ave # 220
Bellingham, WA 98225-7009

Phone

(360) 734-7310

Fax

(360) 647-8336

NPI assigned

Sep 20, 2006

Last updated

May 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Diana Jacobs PHD. Licensed Psychologist PS

  • Clinical Psychologist
  • Bellingham, WA
  • NPI 1245761188
  Authorized official Same address or phone

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1790883353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BELLWETHER WAY STE 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252914",
            "telephone_number": "360-734-7310",
            "fax_number": "360-647-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 HARRIS AVE # 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257009",
            "telephone_number": "360-734-7310",
            "fax_number": "360-647-8336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Bellwether Way Ste 220",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982252914",
            "country_code": "US",
            "telephone_number": "360-734-7310 x3130",
            "fax_number": "360-647-8336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DIANA",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1245761188",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Jackson, M.A., LMFT
• Kinsey Jackson
• Stacey Marie Jackson, PTA
• Taylor Mae Jackson, CDPT
• Allison Joy Jacobs, DDS
• Kellie L. Jacobs, MD
• Pamela S Jacobs, PHD
• Jenna Jacobson, D.C.
• Leslie Jacobson, LMFT
• Margaret A Jacobson, MD

• Clinical Psychologist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.