Provider Demographics
NPI:1356112544
Name:CYNTHIA JACOBSON HEALTH AND WELLNESS INC
Entity type:Organization
Organization Name:CYNTHIA JACOBSON HEALTH AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:805-444-1920
Mailing Address - Street 1:PO BOX 6514
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VLG
Mailing Address - State:CA
Mailing Address - Zip Code:91359-6514
Mailing Address - Country:US
Mailing Address - Phone:805-230-2650
Mailing Address - Fax:805-339-1280
Practice Address - Street 1:325 ROLLING OAKS DR # 110B
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1201
Practice Address - Country:US
Practice Address - Phone:805-230-2650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty