Marylou Jacobo, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

1000026769 Issued in AZ

Practice address

10401 N Cave Creek Rd Lot 306
Phoenix, AZ 85020-1601

Phone

(623) 258-7712

NPI assigned

Dec 29, 2020

Last updated

Dec 29, 2020By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1811584451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 N CAVE CREEK RD LOT 306",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850201601",
            "telephone_number": "623-258-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 N CAVE CREEK RD LOT 306",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850201601",
            "telephone_number": "623-258-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBO",
        "first_name": "MARYLOU",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "AZ",
            "license": "1000026769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Jacob, P.T.
• Stephanie Jacob
• Deborah Ann Jacobi, PNP
• Jaclyn Elyse Jacobi, MD
• Jeanette Jacobo Sanchez
• Bridget Diane Jacobs
• Jennifer Lynn Jacobs, DNP
• Jordan Vernon Jacobs, M.D.
• Juliane Elizabeth Jacobs, LMSW
• Juliette Jacobs

• Nurse's Aide in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Nurse's Aide in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.