Provider Demographics
NPI:1316337017
Name:JACOBSEN, DELYNN M (LMFT)
Entity type:Individual
Prefix:
First Name:DELYNN
Middle Name:M
Last Name:JACOBSEN
Suffix:
Gender:F
Credentials:LMFT
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 1380
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93464-1380
Mailing Address - Country:US
Mailing Address - Phone:530-519-0496
Mailing Address - Fax:866-425-5396
Practice Address - Street 1:385 ALISAL RD
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-3734
Practice Address - Country:US
Practice Address - Phone:805-245-2306
Practice Address - Fax:866-425-5396
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142-421101YA0400X
CAMFC96799106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)