Provider Demographics
NPI:1346539814
Name:STUEBS, JACOB MARTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:MARTIN
Last Name:STUEBS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JACOB
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1522 STATE ST # A
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2514
Mailing Address - Country:US
Mailing Address - Phone:805-665-3835
Mailing Address - Fax:805-617-0228
Practice Address - Street 1:1522 STATE ST # A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2514
Practice Address - Country:US
Practice Address - Phone:805-665-3835
Practice Address - Fax:805-617-0228
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31824111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB217719Medicare PIN