Dr Jacob Andrew Paulsen PHD Licensed Clinical Psychologist Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DR JACOB ANDREW PAULSEN PHD LICENSED CLINICAL PSYCHOLOGIST INC

Practice address

1399 9TH Ave Apt 1517
San Diego, CA 92101-4700

Phone

(619) 800-5499

NPI assigned

Nov 29, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Jacob Andrew Paulsen, PH.D.NPI 1578027199

Title

Ceo

Phone

(619) 800-5499

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Andrew Paulsen, PH.D

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1578027199
  NPD Authorized official

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

{
    "created_epoch": "1732838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732838400000",
    "number": "1912723404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3573",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921631573",
            "telephone_number": "619-800-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 9TH AVE APT 1517",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014700",
            "telephone_number": "619-800-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JACOB ANDREW PAULSEN PHD LICENSED CLINICAL PSYCHOLOGIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-29",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A",
        "authorized_official_last_name": "PAULSEN",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-800-5499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; 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.