Provider Demographics
NPI:1194841528
Name:JACOBS-CAFFEY, LENORE ALICE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LENORE
Middle Name:ALICE
Last Name:JACOBS-CAFFEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 TOWNSGATE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2405
Mailing Address - Country:US
Mailing Address - Phone:805-795-7606
Mailing Address - Fax:
Practice Address - Street 1:2239 TOWNSGATE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2405
Practice Address - Country:US
Practice Address - Phone:805-795-7606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17032103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical