BRUCE K JACOBSON PH D P C NPI 1417913575

NPI Information

  • NPI: 1417913575
  • Provider Name: BRUCE K JACOBSON PH D P C
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Address: 4190 HIGHLAND DR
    SUITE 211
    SALT LAKE CITY, UT
    ZIP 84124
  • Phone: (801) 272-0614

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NPI Details

BRUCE K JACOBSON PH D P C is an adult mental health clinic center in Salt Lake City, UT. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. BRUCE K JACOBSON PH D P C NPI is 1417913575. The provider is registered as an organization entity type.

The provider's business location address is:

4190 HIGHLAND DR
SUITE 211
SALT LAKE CITY, UT
ZIP 84124-600
Phone: (801) 272-0614
Fax: (801) 272-0678

The provider's authorized official is Bruce K Jacobson .
The authorized official title is President And Psychologist and has the following contact phone number (801) 272-0614.

The enumeration date for this NPI number is 4/26/2006 and was last updated on 3/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental Health1162592501UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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