Provider Demographics
NPI:1528197365
Name:JACOBS, MONICA LYNN (PNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNN
Last Name:JACOBS
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LYNN
Other - Last Name:SCHLOSSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:11234 ANDERSON ST TRLR C
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-651-1910
Mailing Address - Fax:909-651-1933
Practice Address - Street 1:250 E CAROLINE ST STE E
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3758
Practice Address - Country:US
Practice Address - Phone:909-651-1910
Practice Address - Fax:909-651-1933
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX782910363LP0200X
CA635787363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics