Provider Demographics
NPI:1346272622
Name:JAKOBSEN, STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:JAKOBSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3466 MT DIABLO BLVD STE C203
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3982
Mailing Address - Country:US
Mailing Address - Phone:925-283-8140
Mailing Address - Fax:925-283-8224
Practice Address - Street 1:3466 MT DIABLO BLVD STE C203
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3982
Practice Address - Country:US
Practice Address - Phone:925-283-8140
Practice Address - Fax:925-283-8224
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0198490Medicare ID - Type Unspecified
CAU03042Medicare UPIN