Healthcare Provider Details

I. General information

NPI: 1669981627
Provider Name (Legal Business Name): STEPHANIE JONES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 S GRAND AVE
LOS ANGELES CA
90007-3304
US

IV. Provider business mailing address

2829 S GRAND AVE
LOS ANGELES CA
90007-3304
US

V. Phone/Fax

Practice location:
  • Phone: 213-699-7000
  • Fax:
Mailing address:
  • Phone: 213-699-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95007423
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: