Provider Demographics
NPI:1609908276
Name:JACOBI, NEAL H (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:H
Last Name:JACOBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3862 HAPPY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-2434
Mailing Address - Country:US
Mailing Address - Phone:916-572-7755
Mailing Address - Fax:916-200-3215
Practice Address - Street 1:1002 W FREMONT AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3031
Practice Address - Country:US
Practice Address - Phone:408-739-2383
Practice Address - Fax:408-749-8198
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG428972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G428971Medicare PIN
CAA89768Medicare UPIN