MEDICARE: MARISHA JONES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1215250550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISHA JONES

Provider Business Mailing Address
First Line	:	84 BROADWAY
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-1910
Country	:	US
Telephone Number	:	510-231-7812
Fax Number	:	510-231-7810

Provider Business Practice Location Address
First Line	:	5617 EASTER ISLAND PL
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6810
Country	:	US
Telephone Number	:	725-777-6833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	04/27/2018

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Directions to “ MARISHA JONES ” Practice Location

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