Provider Demographics
NPI:1114042702
Name:JACOBS, UWE (PHD)
Entity Type:Individual
Prefix:
First Name:UWE
Middle Name:
Last Name:JACOBS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MARKET ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2102
Mailing Address - Country:US
Mailing Address - Phone:415-546-2080
Mailing Address - Fax:415-546-2084
Practice Address - Street 1:703 MARKET ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2102
Practice Address - Country:US
Practice Address - Phone:415-546-2080
Practice Address - Fax:415-546-2084
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 15165103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist