Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jacob Panquale Panzarella, PHD

Individual provider Clinical Neuropsychologist · NPI 1164738464

Dr. Jacob Panquale Panzarella, PHD is a Clinical Neuropsychologist in San Rafael, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2010
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

4040 Civic Center Dr Ste 200
San Rafael, CA 94903-4150
Phone: (415) 381-0300
Fax: (415) 898-4361
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence PSY3581 (CA)

Record details

NPI number1164738464
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedAugust 24, 2010
Last updated in NPPESAugust 24, 2010

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