Basic Information
Provider Information
NPI: 1568885192
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: JAMAL
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6157 N FIGARDEN DR APT 202
Address2:  
City: FRESNO
State: CA
PostalCode: 937227960
CountryCode: US
TelephoneNumber: 5592462200
FaxNumber:  
Practice Location
Address1: 1225 M ST
Address2:  
City: FRESNO
State: CA
PostalCode: 93721
CountryCode: US
TelephoneNumber: 5596009360
FaxNumber: 5594886826
Other Information
ProviderEnumerationDate: 02/03/2014
LastUpdateDate: 07/30/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X71325CAN Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
106H00000X100111CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


Home