Request Medical Record - Jacobo Physical Therapy, Inc

Request Medical Record / Patient Status

If you would like to give us some feedback on our service and to comment on those areas that you feel were exceptional and those below par, please take the time to fill out our survey or leave your thoughts in our testimonial section.

On a scale of 1 to 10, with 10 being best please rate the following categories.

Kathleen Avalos

Office manager

EMAIL: kavalos@jacobopt.com

PHONE: 661-558-1094

Darius Populin

Head Office Manager

EMAIL: [email protected]

PHONE: 661-558-1099

Medical Records/Patient Status:

Please input your client’s information and attach your subpoena/letter of representation.

First Name

Last Name

Contact

Patient Address

City

State

Postal Code

Patient Date of Birth

Referring Physician Name

NPI Number

Referring Physician Phone Number

Reason for Referral/Patient Diagnosis Information

How Should We Contact Regarding This Referral?

Fax Number

Submit Your Form

For more information contact one of the following:

Darius Populin
Director of Operations
Email:[email protected]
Phone: 661-558-1099

Natisha Rafal
Medical Records Specialist
EMAIL: nrafal@jacobopt.com
PHONE: 661-558-1094

Stefany Vazquez
Medical Records/Patient Status

EMAIL: svazquez@jacobopt.com

PHONE: 661-558-1101

Downtown Clinic

5300 California Ave. Suite 110
Bakersfield, CA 93309

Monday – Friday:
9 AM – 6 PM
Saturday & Sunday:
Closed

Phone: (661) 631-8793 x1

Northwest / Aquatic Center

3850 Riverlakes Dr Suite A
Bakersfield, CA 93312

Monday – Friday:
9 AM – 6 PM

Sunday: 9am to 4pm
Saturday Closed:

Phone: (661) 529-2303 x1

Orthopedic & Musculoskeletal Rehabilitation

Neurological & Balance Disorders

Women’s Health & Specialized Therapy

Pediatric & Developmental Conditions

Wellness & Complementary Therapies