Basic Information
Provider Information
NPI: 1437221751
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: DAVID
MiddleName: JOSEPH
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1439 HERITAGE OAK DR
Address2:  
City: CHICO
State: CA
PostalCode: 95928
CountryCode: US
TelephoneNumber: 5308997907
FaxNumber:  
Practice Location
Address1: 592 RIO LINDO AVENUE
Address2:  
City: CHICO
State: CA
PostalCode: 95926
CountryCode: US
TelephoneNumber: 5308912775
FaxNumber: 5308956547
Other Information
ProviderEnumerationDate: 11/14/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X  X Behavioral Health & Social Service ProvidersSocial Worker 
225C00000X  X Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor 

No ID Information.


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