Provider Demographics
NPI:1942385547
Name:JONES, CAROL JEAN (QMHP)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JEAN
Last Name:JONES
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 SAN PABLO AVE APT 417
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-4363
Mailing Address - Country:US
Mailing Address - Phone:415-424-7586
Mailing Address - Fax:415-499-3080
Practice Address - Street 1:161 MITCHELL BLVD
Practice Address - Street 2:STE. #101
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2068
Practice Address - Country:US
Practice Address - Phone:415-507-2824
Practice Address - Fax:415-499-3080
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor