Individual provider Active NPI

Jacob Felix Spencer, PH.D.

  • Clinical Psychologist
  • Eureka, CA
National Provider Identifier
1982921417
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY27901 Issued in CA
Practice address
326 I St # 108
Eureka, CA 95501-0522
Phone
(530) 310-7818
NPI assigned
Apr 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CA
Clinical Psychologist 103TC0700X PSY27901 CA Primary

Addresses

Primary practice location

326 I St # 108
Eureka, CA 95501-0522

Mailing address

326 I St # 108
Eureka, CA 95501-0522
Phone (530) 310-7818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220405001544 CA Practitioner - Clinical Psychologist 7214323963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Julia Evans PHD Psychology PCGroup PAC ID 0446510309, 17 clinicians

Practice addresses (Care Compare)

940 S Coast Dr
Suite 225
Costa Mesa, CA 92626-7757
Phone (949) 743-1457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY27901CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Numinous Psychotherapy Inc Clinical CurrentSince Jun 23, 2025 Accepting new patients
Julia Evans PHD Psychology PC Clinical CurrentSince Dec 29, 2021 Accepting new patients

Locations

940 S Coast Dr
Ste 225
Costa Mesa, CA 92626
Phone (949) 742-1457

326 I St
Eureka, CA 95501
Phone (530) 310-7818

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1982921417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 I ST # 108",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010522",
            "telephone_number": "530-310-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 I ST # 108",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010522",
            "telephone_number": "530-310-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "JACOB",
        "middle_name": "FELIX",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.