Shelley J Jacobs, CNM | |
25825 Vermont Ave, Harbor City, CA 90710-3518 | |
(310) 325-5111 | |
Not Available |
Full Name | Shelley J Jacobs |
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Gender | Female |
Speciality | Advanced Practice Midwife |
Location | 25825 Vermont Ave, Harbor City, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265633150 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367A00000X | Advanced Practice Midwife | NMW1066 (California) | Primary |
Entity Name | Southern California Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
Mailing Address | Practice Location Address |
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Shelley J Jacobs, CNM 25825 Vermont Ave, Harbor City, CA 90710-3518 Ph: (310) 325-5111 | Shelley J Jacobs, CNM 25825 Vermont Ave, Harbor City, CA 90710-3518 Ph: (310) 325-5111 |
Kerry Mc Cabe, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 25825 Vermont Ave, Harbor City, CA 90710 Phone: 310-325-5111 | |
Marisa Chong, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 25825 Vermont Ave, Harbor City, CA 90710 Phone: 310-325-5111 | |
Esther L Canales, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 25825 Vermont Ave, Harbor City, CA 90710 Phone: 310-325-5111 |