Active NPI
Kimberly Erin Jacobs, MS
- School Psychologist
- Marana, AZ
National Provider Identifier
1952566911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4030966
- Practice address
- 11279 W Grier Rd
Marana, AZ 85653-9609 - Phone
- (520) 682-4782
- Fax
- (520) 682-4818
- NPI assigned
- Jul 18, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4030966 | AZ | Primary |
Addresses
Primary practice location
11279 W Grier Rd
Marana, AZ 85653-9609
Mailing address
5751 N Kolb Rd
Apartment # 4103
Tucson, AZ 85750-0873
Phone (520) 395-1391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4030966 | AZ | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216339200000",
"number": "1952566911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5751 N KOLB RD",
"address_2": "APARTMENT # 4103",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857500873",
"telephone_number": "520-395-1391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11279 W GRIER RD",
"city": "MARANA",
"state": "AZ",
"postal_code": "856539609",
"telephone_number": "520-682-4782",
"fax_number": "520-682-4818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "KIMBERLY",
"middle_name": "ERIN",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-18",
"last_updated": "2008-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "AZ",
"license": "4030966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marana, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.