Donna Ann Jacobsen, D. O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A9734 Issued in CA

Practice address

2850 Telegraph Ave
Suite 130
Berkeley, CA 94705-1192

Phone

(510) 883-9883

Fax

(510) 843-0804

NPI assigned

Sep 26, 2006

Last updated

Jul 10, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Sutter East Bay Medical Foundation

  • Clinical Medical Laboratory
  • Berkeley, CA
  • NPI 1831381623
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1801997051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 COLON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941272106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 TELEGRAPH AVE",
            "address_2": "SUITE 130",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051192",
            "telephone_number": "510-883-9883",
            "fax_number": "510-843-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "DONNA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D. O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "HI",
            "license": "1013",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Donnelly, Licensed Clinical Social Worker, Inc.
• Lynanne Jacob, R.N.
• Mack Jacob, DDS
• James Harris Jacobs, PH.D.
• Carl H. Jacobsen, O.D.
• Aaron Robert Jacobson, M.A.
• Karmit Jacobson
• Megan Elliott Jacoby
• Nicolas Arthur Jadot, LMFT
• Tanya Jaikaran

• Family Medicine Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.