Bruce Kenneth Jacobson in Salt Lake City - Psychologist
Bruce Kenneth Jacobson - NPI 1679743009
Bruce Kenneth Jacobson is a Psychologist in Salt Lake City, Utah. Bruce Kenneth Jacobson practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Bruce Kenneth Jacobson is 1679743009. The last update date is 2018-03-14.
Bruce Kenneth Jacobson's current location address is 4190 Highland Dr, Salt Lake City, Utah. You can contact this provider via phone number 8012720614. The mailing address for Bruce Kenneth Jacobson is 4190 Highland Dr, Salt Lake City, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bruce Kenneth Jacobson |
|---|---|
| Address | 4190 Highland Dr, Salt Lake City, Utah |
| Phone Number | 8012720614 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D., P.C |
NPI Number Detail
| NPI Number | 1679743009 |
|---|---|
| Provider Enumeration Date | 2008-02-29 |
| Last Updated Date | 2018-03-14 |
Provider Mailing Address Detail
| Address | 4190 Highland Dr |
|---|---|
| City | Salt Lake City |
| State | Utah (UT) |
| Post Code | 841242600 |
| Phone Number | 8012720614 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 450510082 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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What is the unique 10-digit identifier code issued to Bruce Kenneth Jacobson by the Centers for Medicare & Medicaid Services?
The Bruce Kenneth Jacobson has been assigned the NPI (National Provider Identifier) 1679743009 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Bruce Kenneth Jacobson's physical address?
The Bruce Kenneth Jacobson is physically located at 4190 Highland Dr, in the city of Salt Lake City, UT, with the postal code 841242600.
What is Bruce Kenneth Jacobson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Bruce Kenneth Jacobson is Psychologist, and the taxonomy classification code that categorizes this area of expertise is 103T00000X.
On what date did Bruce Kenneth Jacobson receive its 1679743009 assignment from the Centers for Medicare & Medicaid Services?
The Bruce Kenneth Jacobson was assigned its 1679743009 on 2008-02-29, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Bruce Kenneth Jacobson last refreshed?
The information related to the Bruce Kenneth Jacobson, including its address, specialty, and other relevant details, was last updated on 2018-03-14.