Basic Information
| Provider Information | |||||||||
| NPI: | 1619378288 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES-PIERCE | ||||||||
| FirstName: | RAQUEL | ||||||||
| MiddleName: | RENEE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2085 RUSTIN AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925072498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519557108 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 41002 COUNTY CENTER DR STE 320 | ||||||||
| Address2: | |||||||||
| City: | TEMECULA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925916027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516006355 | ||||||||
| FaxNumber: | 9516006365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2014 | ||||||||
| LastUpdateDate: | 05/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | ASW72480 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 104100000X | N | Behavioral Health & Social Service Providers | Social Worker | 390200000X | CA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 101YM0800X | LCSW99745 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | LCSW99745 | 01 | CA | LICENSE | OTHER |