Basic Information
Provider Information
NPI: 1629053038
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: APRIL
MiddleName: ELLEN
NamePrefix: MS.
NameSuffix:  
Credential: MFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: L600 WEEOT WAY
Address2:  
City: ARCATA
State: CA
PostalCode: 95521
CountryCode: US
TelephoneNumber: 7078255060
FaxNumber:  
Practice Location
Address1: 609 J ST
Address2:  
City: ARCATA
State: CA
PostalCode: 955216128
CountryCode: US
TelephoneNumber: 7078255060
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/08/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X31087CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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