| Naomi T. Jacobs, Ph.d., P.a. | |
|
100 Executive Way Suite 207 Ponte Vedra Beach FL 32082-2715 | |
| (904) 687-6336 | |
| Not Available |
| Full Name | Naomi T. Jacobs, Ph.d., P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 100 Executive Way, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | Naomi Jacobs (PSYCHOLOGIST) |
| Authorized Official Contact | 9046876336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Naomi T. Jacobs, Ph.d., P.a. 100 Executive Way Suite 207 Ponte Vedra Beach FL 32082-2715 Ph: (904) 687-6336 | Naomi T. Jacobs, Ph.d., P.a. 100 Executive Way Suite 207 Ponte Vedra Beach FL 32082-2715 Ph: (904) 687-6336 |
| NPI Number | 1184996704 |
|---|---|
| Provider Enumeration Date | 01/27/2012 |
| Last Update Date | 09/17/2013 |
| Medicare PECOS PAC ID | 0547420242 |
|---|---|
| Medicare Enrollment ID | O20120404000104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184996704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Naomi T Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275641110 PECOS PAC ID: 8224298930 Enrollment ID: I20120423000250 |
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