Healthcare Provider Details

I. General information

NPI: 1366566598
Provider Name (Legal Business Name): VERNESSA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 A ST
HAYWARD CA
94541-4122
US

IV. Provider business mailing address

1515 MARKET AVE
SAN PABLO CA
94806-4357
US

V. Phone/Fax

Practice location:
  • Phone: 510-593-4417
  • Fax: 510-538-5215
Mailing address:
  • Phone: 510-232-7571
  • Fax: 510-235-2545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: