Basic Information
| Provider Information | |||||||||
| NPI: | 1356786297 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | LEAH | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 CHERRYWOOD ST | ||||||||
| Address2: | |||||||||
| City: | FILLMORE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930152180 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 864 E SANTA CLARA ST | ||||||||
| Address2: | |||||||||
| City: | VENTURA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930012939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056431446 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2013 | ||||||||
| LastUpdateDate: | 05/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 66709 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 115850 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.