Provider Demographics
NPI:1902115405
Name:JACOBI, ROBIN L (L AC)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:L
Last Name:JACOBI
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:CA
Mailing Address - Zip Code:95018-9648
Mailing Address - Country:US
Mailing Address - Phone:831-335-8335
Mailing Address - Fax:831-335-8335
Practice Address - Street 1:912 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:CA
Practice Address - Zip Code:95018-9648
Practice Address - Country:US
Practice Address - Phone:831-335-8335
Practice Address - Fax:831-335-8335
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7732171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist