Basic Information
Provider Information
NPI: 1154707826
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: HANNAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BACHELOR OF SOCIA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3780 ROSIN CT
Address2: SUITE 110
City: SACRAMENTO
State: CA
PostalCode: 958341646
CountryCode: US
TelephoneNumber: 9164410226
FaxNumber:  
Practice Location
Address1: 3870 ROSIN CT
Address2: SUITE 130
City: SACRAMENTO
State: CA
PostalCode: 958341620
CountryCode: US
TelephoneNumber: 9163631153
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/05/2015
LastUpdateDate: 08/05/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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