Provider Demographics
NPI:1134182363
Name:JACOBS, CHERYL WENELL (RN, ANP, MS)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:WENELL
Last Name:JACOBS
Suffix:
Gender:F
Credentials:RN, ANP, MS
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:BETH
Other - Last Name:WENELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, ANP, MS
Mailing Address - Street 1:154 JUANITA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1741
Mailing Address - Country:US
Mailing Address - Phone:415-665-1548
Mailing Address - Fax:
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:WOMEN'S CLINIC 11C2
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-750-2174
Practice Address - Fax:415-750-6995
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236778363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health