1134182363 NPI number — MS. CHERYL WENELL JACOBS RN, ANP, MS

Table of content: ZAID AKHRAS M.D (NPI 1174312714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134182363 NPI number — MS. CHERYL WENELL JACOBS RN, ANP, MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JACOBS
Provider First Name:
CHERYL
Provider Middle Name:
WENELL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN, ANP, MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WENELL
Provider Other First Name:
CHERYL
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, ANP, MS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1134182363
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
154 JUANITA WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94127-1741
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-665-1548
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4150 CLEMENT ST
Provider Second Line Business Practice Location Address:
WOMEN'S CLINIC 11C2
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94121-1545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-750-2174
Provider Business Practice Location Address Fax Number:
415-750-6995
Provider Enumeration Date:
04/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  236778 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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