Search › California › 367500000X
Jace Jacobsen
NPI 1871116004 · on the registry since 2020 · sole proprietor
Practice
- Address
- 6442 Gloria Dr
Huntington Beach, CA 92647 - Phone
- (805) 814-2463
Registry record
- Primary taxonomy
- 367500000X
367500000X
- Also registered as
- 163W00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-10-12
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