Provider Demographics
NPI:1023025392
Name:JACOBS, SHARON (DC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17750 SHERMAN WAY
Mailing Address - Street 2:#300
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-3380
Mailing Address - Country:US
Mailing Address - Phone:818-705-7200
Mailing Address - Fax:818-343-0805
Practice Address - Street 1:22030 SHERMAN WAY
Practice Address - Street 2:#101
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1855
Practice Address - Country:US
Practice Address - Phone:818-716-9434
Practice Address - Fax:818-716-4123
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor