Provider Demographics
NPI:1316718711
Name:INSIDE OUT PSYCHOLOGY INC
Entity type:Organization
Organization Name:INSIDE OUT PSYCHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAKOB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-429-8787
Mailing Address - Street 1:800 POLLARD RD STE B201
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1429
Mailing Address - Country:US
Mailing Address - Phone:650-429-8787
Mailing Address - Fax:
Practice Address - Street 1:800 POLLARD RD STE B201
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1429
Practice Address - Country:US
Practice Address - Phone:650-429-8787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty