Basic Information
Provider Information | |||||||||
NPI: | 1407847734 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | JONES | ||||||||
FirstName: | STEVE | ||||||||
MiddleName: | KENT | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 5855 OLIVAS PARK DR | ||||||||
Address2: |   | ||||||||
City: | VENTURA | ||||||||
State: | CA | ||||||||
PostalCode: | 930037672 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8056672801 | ||||||||
FaxNumber: | 8056672865 | ||||||||
Practice Location | |||||||||
Address1: | 2921 SAVIERS RD | ||||||||
Address2: |   | ||||||||
City: | OXNARD | ||||||||
State: | CA | ||||||||
PostalCode: | 930335314 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8054875588 | ||||||||
FaxNumber: | 8054875589 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/04/2005 | ||||||||
LastUpdateDate: | 04/25/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | C43042 | CA | N |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   | 207PE0004X | C43042 | CA | N |   | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207Q00000X | C 43042 | CA | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   | 207QG0300X | C 43042 | CA | N |   | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 2083X0100X | C 43042 | CA | N |   | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
ID Information
ID | Type | State | Issuer | Description | RHM08608F | 05 | CA |   | MEDICAID | 00C430420 | 05 | CA |   | MEDICAID | 058553 | 01 | CA | RH MEDICARE | OTHER | 95-1683892 | 01 | CA | OTHER INSURANCE | OTHER | 050394 | 01 | CA | BLUE CROSS | OTHER | RHM08609F | 05 | CA |   | MEDICAID | ZZT40394F | 05 | CA |   | MEDICAID | RHM18553H | 05 | CA |   | MEDICAID |