Healthcare Provider Details

I. General information

NPI: 1114544814
Provider Name (Legal Business Name): LATASHA YVETTE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 W CLINTON AVE UNIT 311
FRESNO CA
93705-4218
US

IV. Provider business mailing address

PO BOX 12531
FRESNO CA
93778-2531
US

V. Phone/Fax

Practice location:
  • Phone: 559-264-7521
  • Fax:
Mailing address:
  • Phone: 559-246-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139961
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: