DR. PATRICE ALANA JACOB PH.D. NPI 1669919148

NPI Information

  • NPI: 1669919148
  • Provider Name: DR. PATRICE ALANA JACOB, PH.D.
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1361 S 15TH WAY
    RIDGEFIELD, WA
    ZIP 98642
  • Phone: (360) 643-9217

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NPI Details

DR. Patrice Alana Jacob, PH.D. is a mental health counselor in Ridgefield, WA with 10 years of experience. DR. Patrice Alana Jacob, PH.D. NPI is 1669919148. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1361 S 15TH WAY
RIDGEFIELD, WA
ZIP 98642-826
Phone: (360) 643-9217
Fax: (503) 678-9751

The NPI 1669919148 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 1/23/2017 and was last updated on 6/4/2020.

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
1101YM0800XCounselorMental HealthMC60704526WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12082041MEDICAIDWASHINGTON

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: 3/30/2025

NPI Synchronization or Removal

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