| Doctor Name: | BRIAN EDWIN JACOBSON |
| NPI Number: | 1093065336 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 39343 |
| Business Practice Address: | 500 Paseo Camarillo Suite 105 Camarillo, CA - 930105900 |
| Business Phone Number: | 8059876851 |
| Business Fax Number: | |
| Mailing Address: | 132 Cindy Ave, NEWBURY PARK |
| State: | CA |
| Postal Code: | 913204421 |
| Phone Number: | 9516601259 |
| Fax Number: | |
| NPI Enumeration Date: | 09/13/2012 |
| NPI Last Update Date: | 09/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 39343 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |