Healthcare Provider Details

I. General information

NPI: 1760394381
Provider Name (Legal Business Name): JILL JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 N LA BREA AVE # 135
INGLEWOOD CA
90302-2205
US

IV. Provider business mailing address

815 N LA BREA AVE # 135
INGLEWOOD CA
90302-2205
US

V. Phone/Fax

Practice location:
  • Phone: 323-849-4309
  • Fax:
Mailing address:
  • Phone: 323-849-4309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number159992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: