Provider Demographics
NPI:1952449027
Name:JACOBS, MEGHAN S (PA)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:S
Last Name:JACOBS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:S
Other - Last Name:WILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:130 SUTTER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4009
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:1627 I ST NW STE 800
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-4088
Practice Address - Country:US
Practice Address - Phone:202-660-0015
Practice Address - Fax:202-660-0025
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003429363AM0700X
DCPA031221363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical