Provider Demographics
NPI:1326103771
Name:JAK, AMY J (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:J
Last Name:JAK
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:3350 LA JOLLA VILLAGE DR
Mailing Address - Street 2:151B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92161-0002
Mailing Address - Country:US
Mailing Address - Phone:858-642-3742
Mailing Address - Fax:858-642-1458
Practice Address - Street 1:UCSD NEUROPSYCHOLOGICAL ASSOCIATES
Practice Address - Street 2:9500 GILMAN DR. (0603)
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-0603
Practice Address - Country:US
Practice Address - Phone:858-822-5791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-08-13
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Provider Licenses
StateLicense IDTaxonomies
CA21113103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist