Provider Demographics
NPI:1275706327
Name:JACOBS, ANNE BURLEIGH (PT, PHD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:BURLEIGH
Last Name:JACOBS
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FREMONT AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6093
Mailing Address - Country:US
Mailing Address - Phone:408-390-8313
Mailing Address - Fax:866-497-3512
Practice Address - Street 1:1000 FREMONT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-6093
Practice Address - Country:US
Practice Address - Phone:408-390-8313
Practice Address - Fax:866-497-3512
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist