Provider Demographics
NPI:1215073572
Name:JACOBSON, JOANNE FRANCES (MD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:FRANCES
Last Name:JACOBSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7793
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94120-7793
Mailing Address - Country:US
Mailing Address - Phone:925-951-1366
Mailing Address - Fax:
Practice Address - Street 1:66 BOVET RD
Practice Address - Street 2:STE 103
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3125
Practice Address - Country:US
Practice Address - Phone:650-570-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52210207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G522100Medicaid
A52199Medicare UPIN