NPI Details
DR. Richard Samuel Jacobson, M,D, is a psychiatry psychiatry neurology in Granada Hills, CA with 60 years of experience. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. DR. Richard Samuel Jacobson, M,D, NPI is 1952443673. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:1966
The provider's business location address is:
10515 BALBOA BL.
SUITE 250
GRANADA HILLS, CA
ZIP 91344
Phone: (818) 831-2343
The NPI 1952443673 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, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 2/12/2007 and was last updated on 8/21/2012.
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 |
| 1 | 2080P0006X | Pediatrics | Developmental - Behavioral Pediatrics | G15588 | CALIFORNIA | No |
| 2 | 2080P0008X | Pediatrics | Neurodevelopmental Disabilities | G15588 | CALIFORNIA | No |
| 3 | 2084P0800X | Psychiatry & Neurology | Psychiatry | G15588 | CALIFORNIA | Yes |
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 |
| 1 | 953408568 | OTHER | | TAX ID NUMBER |
| 2 | G15588 | OTHER | CALIFORNIA | STATE LICENSE NUM |
| 3 | 00G155880 | MEDICAID | CALIFORNIA | |
