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Search › California › 103K00000X

Jacob Miceli

NPI 1619447323 · on the registry since 2018

Practice

Address
5501 Antique Rose Way
Riverbank, CA 95367
Phone
(209) 521-4791
Organisation at this address
Central Valley Autism Project, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
1,480

Registry record

Primary taxonomy
103K00000X
103K00000X
Also registered as
106S00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-06-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California