Provider Demographics
NPI:1255506457
Name:STRANGE, JACOB CHRISTOPHER (MFT)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:CHRISTOPHER
Last Name:STRANGE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MING AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4689
Mailing Address - Country:US
Mailing Address - Phone:661-834-8341
Mailing Address - Fax:
Practice Address - Street 1:5500 MING AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4689
Practice Address - Country:US
Practice Address - Phone:661-834-8341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT25871106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist