Provider Demographics
NPI:1861641664
Name:JACOBS, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOAH
Other - Middle Name:
Other - Last Name:SINGMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6650 DANA ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1110
Mailing Address - Country:US
Mailing Address - Phone:510-684-4867
Mailing Address - Fax:
Practice Address - Street 1:6650 DANA ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1110
Practice Address - Country:US
Practice Address - Phone:510-684-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay