| Diana Jacobs Phd. Licensed Psychologist Ps | |
|
960 Harris Ave Ste 205 Bellingham WA 98225-7025 | |
| (360) 734-7310 | |
| (360) 647-8336 |
| Full Name | Diana Jacobs Phd. Licensed Psychologist Ps |
|---|---|
| Speciality | Psychologist |
| Location | 960 Harris Ave Ste 205, Bellingham, Washington |
| Authorized Official Name and Position | Diana Jacobs (OWNER) |
| Authorized Official Contact | 3607347310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diana Jacobs Phd. Licensed Psychologist Ps 12 Bellwether Way Ste 220 Bellingham WA 98225-2914 Ph: (360) 734-7310 | Diana Jacobs Phd. Licensed Psychologist Ps 960 Harris Ave Ste 205 Bellingham WA 98225-7025 Ph: (360) 734-7310 |
| NPI Number | 1245761188 |
|---|---|
| Provider Enumeration Date | 03/22/2017 |
| Last Update Date | 06/03/2019 |
| Medicare PECOS PAC ID | 2567705338 |
|---|---|
| Medicare Enrollment ID | O20190517001388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245761188 | NPI | - | NPPES |
| 1790883353 | Other | WA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY00002516 (Washington) | Primary |
| Provider Name | Diana Jacobs |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1790883353 PECOS PAC ID: 1557604337 Enrollment ID: I20200316002729 |
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