Clarissa Jacobo

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

11080 W Washington Blvd
Culver City, CA 90232

Phone

(818) 747-4710

NPI assigned

Mar 28, 2024

Last updated

May 13, 2025By 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)

Not enrolled

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1902657935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27066 HIDAWAY AVE UNIT 6",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913514117",
            "telephone_number": "818-747-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11080 W WASHINGTON BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90232",
            "telephone_number": "818-747-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBO",
        "first_name": "CLARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tashe'E Marie Jackson
• Yvette Antoinette Jackson, LCSW
• Jacob M Tsadok MD Inc
• Jeena Jacob, APRN
• Andrea Jacobo
• Evelyn Jacobo
• Lizbeth Jacobo
• Elena Rene Jacobson
• Lisa Jaffe, LCSW
• Sabrina Jaffe

• Community Health Worker in Culver City, CA
• Providers in Culver City, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.