Provider Demographics
NPI:1780186817
Name:ENGELSKIRGER, JACOB FEINER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:FEINER
Last Name:ENGELSKIRGER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6545
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6545
Mailing Address - Country:US
Mailing Address - Phone:510-343-3567
Mailing Address - Fax:
Practice Address - Street 1:305 VELOCITY WAY
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-4803
Practice Address - Country:US
Practice Address - Phone:650-524-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31090103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical