Individual provider · Type 1 NPI
Susan M. Jacob, PhD
Professional Counselor · Newport Beach, CA
NPI number
1245246503
Active
Practice location
1101 Dove St, Suite 160
Newport Beach, CA 92660-2839
Fax (949) 851-5123
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | MFT25105 (CA) |
Professional Counselor: Definition to come...
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About NPI 1245246503
Susan M. Jacob, PhD's National Provider Identifier is 1245246503, issued on Jul 31, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Newport Beach, CA. The record was last updated on Jul 8, 2007.