Provider Demographics
NPI:1053513960
Name:JACOUBS-BEYE, JANIRA (PSYD)
Entity type:Individual
Prefix:DR
First Name:JANIRA
Middle Name:
Last Name:JACOUBS-BEYE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 AMBER CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3661
Mailing Address - Country:US
Mailing Address - Phone:626-625-2094
Mailing Address - Fax:
Practice Address - Street 1:5100 E LA PALMA AVE
Practice Address - Street 2:STE.104
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2081
Practice Address - Country:US
Practice Address - Phone:714-261-9832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2016-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23677103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical