Healthcare Provider Details

I. General information

NPI: 1457260366
Provider Name (Legal Business Name): VIRGINIA REBECCA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 E PALMER WASILLA HWY
PALMER AK
99645-8467
US

IV. Provider business mailing address

2521 E MOUNTAIN VILLAGE DR STE B626
WASILLA AK
99654-7373
US

V. Phone/Fax

Practice location:
  • Phone: 907-206-4421
  • Fax:
Mailing address:
  • Phone: 907-206-4421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: