Individual provider · Type 1 NPI

Shiny Jacob

Psychiatric/Mental Health Nurse Practitioner · Redlands, CA

NPI number 1700638293 Active

Practice location

1030 Nevada St
Redlands, CA 92374-2957

Mailing address

5360 Corison Way
Fontana, CA 92336-5995

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X95028911 (CA)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1700638293

Shiny Jacob's National Provider Identifier is 1700638293, issued on Apr 5, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Redlands, CA. The record was last updated on Jun 11, 2026.