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JACLYN JACOBS LPCC
NPI 1376173377
Counselor - Mental Health in San Diego, CA

Active since January 19, 2020Opted out of Medicare · through Oct 8, 2026
10755 SCRIPPS POWAY PKWY STE F412, SAN DIEGO, CA 92131(267) 388-0465 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 11, 2025, Oct 9, 2024, Jan 19, 2020 (3 updates tracked since 2020).

About Jaclyn Jacobs Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN JACOBS LPCC (NPI 1376173377) is an individual mental health provider in San Diego, California, licensed in Pennsylvania (PC013727) and active in the NPI registry since January 2020. She has opted out of Medicare through October 8, 2026.

NPPES Registry Identity

NPI1376173377
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACLYN JACOBSCredential: LPCC
Location Address10755 SCRIPPS POWAY PKWY STE F412San Diego, CA 92131-3924
Mailing Address10755 Scripps Poway Pkwy Ste F412San Diego, CA 92131-3924 · (267) 388-0465
Phone(267) 388-0465
Sole ProprietorYes
Enumeration DateJanuary 19, 2020
Last NPPES UpdateSeptember 11, 20253 updates tracked since enumeration
NPPES CertifiedOctober 9, 2024
✔ NPI 1376173377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in PA · PC013727
10755 SCRIPPS POWAY PKWY STE F412, San Diego, CA 92131
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jaclyn Jacobs Lpcc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 8, 2024 through October 8, 2026.

Opt-Out Effective DateOctober 8, 2024
Opt-Out In Effect ThroughOctober 8, 2026Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaclyn Jacobs's NPI number?

The NPI number for Jaclyn Jacobs is 1376173377. It was assigned to this individual provider in the NPPES registry on January 19, 2020.

Where is Jaclyn Jacobs located?

Jaclyn Jacobs practices at 10755 Scripps Poway Pkwy Ste F412, San Diego, CA 92131. The listed phone number is (267) 388-0465.

What is Jaclyn Jacobs's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jaclyn Jacobs enrolled in Medicare?

No. Jaclyn Jacobs has opted out of Medicare through October 8, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jaclyn Jacobs was last updated on September 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.