Provider Demographics
NPI:1750662854
Name:JAKOBSON, HARRY CHRISTIAN JR (LCSW)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:CHRISTIAN
Last Name:JAKOBSON
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 DARTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7150
Mailing Address - Country:US
Mailing Address - Phone:530-440-2716
Mailing Address - Fax:
Practice Address - Street 1:1428 DARTWOOD DR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7150
Practice Address - Country:US
Practice Address - Phone:530-487-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA724951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1750662854Medicare NSC