Venter, Jacob J
Venter, Jacob J is an individual health care provider with primary practice located at Cha - Psychiatry - Adolescent Assessment Unit 1493 Cambridge Street, Cambridge MA 02139. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Venter, Jacob J can be contacted via phone (617) 575-5460.Contact Information
Primary practice address
Cha - Psychiatry - Adolescent Assessment Unit 1493 Cambridge Street
Cambridge MA 02139
Phone: (617) 575-5460
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 32812 | Arizona |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 210085 | Massachusetts |
Profile Details
| NPI number | 1063402378 |
|---|---|
| LBN Legal business name | Venter, Jacob J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Aug 4th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063402378 | NPPES |
| Massachusetts | Other | J25693 | BCBS MA |
| Massachusetts | Other | S400413978 | BCBS MA |
| Massachusetts | MEDICAID | 110034921A | BCBS MA |
| Massachusetts | Other | 459239 | BCBS MA |
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