Individual provider · Type 1 NPI

Tracy Jacobsen

Addiction (Substance Use Disorder) Counselor · Riverside, CA

NPI number 1144593237 Active

Practice location

3757 Elizabeth St
Riverside, CA 92506-2508

Call (951) 216-7300 Map

Fax (951) 216-7333

Mailing address

PO Box 549
Lake Elsinore, CA 92531-0549

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1144593237

Tracy Jacobsen's National Provider Identifier is 1144593237, issued on Feb 20, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Riverside, CA. The record was last updated on Feb 20, 2012.