Provider Demographics
NPI:1821698481
Name:JACOBS, SANDRA ESPINOSA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ESPINOSA
Last Name:JACOBS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 NACOGDOCHES RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2216
Mailing Address - Country:US
Mailing Address - Phone:210-370-7545
Mailing Address - Fax:
Practice Address - Street 1:1868 NACOGDOCHES RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2216
Practice Address - Country:US
Practice Address - Phone:210-370-7545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1567103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst