Provider Demographics
NPI:1821184516
Name:JACOBS, YOLANDA ANTOINETTE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:ANTOINETTE
Last Name:JACOBS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 22190
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94626
Mailing Address - Country:US
Mailing Address - Phone:916-683-5705
Mailing Address - Fax:
Practice Address - Street 1:200 WEBSTER STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607
Practice Address - Country:US
Practice Address - Phone:510-587-2635
Practice Address - Fax:510-587-2794
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54192183500000X
OR0014651183500000X
NV16391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist