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

Russell Jacobs Jr.

Individual provider Rehabilitation Practitioner · NPI 1609572585

Russell Jacobs Jr. is a Rehabilitation Practitioner in Van Nuys, California. Licensed in California. Registered with an NPI since 2023.

Licensed in
CA
In the registry since
2023

Practice location Address checks out

16650 Sherman Way
Van Nuys, CA 91406-3782
Phone: (818) 901-4836
Fax: (818) 376-0044
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X (CA)

Record details

NPI number1609572585
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 2, 2023
Last updated in NPPESFebruary 2, 2023
Certification dateFebruary 2, 2023
Mailing address13820 Victory Blvd Apt 206, Van Nuys, CA 91401-2332

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