Provider Demographics
NPI:1578771846
Name:JACOBSON, JULIANA MARIA (MSRNCS)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:MARIA
Last Name:JACOBSON
Suffix:
Gender:F
Credentials:MSRNCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 WASHINGTON AVE
Mailing Address - Street 2:APT. 101
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2637
Mailing Address - Country:US
Mailing Address - Phone:240-486-6498
Mailing Address - Fax:301-583-3735
Practice Address - Street 1:8607 2ND AVE
Practice Address - Street 2:SUITE 407A
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3355
Practice Address - Country:US
Practice Address - Phone:240-486-6498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR070832163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult