Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bruce Kenneth Jacobson, PHD, PC

Individual provider Psychologist · NPI 1679743009

Bruce Kenneth Jacobson, PHD, PC is a Clinical Psychologist in Salt Lake City, Utah. Qualified in 1989, 37 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
37
Licensed in
UT
In the registry since
2008
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

4190 Highland Dr Ste 211
Salt Lake City, UT 84124-2600
Phone: (801) 272-0614
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 450510082 (UT)

Record details

NPI number1679743009
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , PC
Sole proprietorYes
NPI enumeratedFebruary 29, 2008
Last updated in NPPESMarch 14, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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