Healthcare Provider Details

I. General information

NPI: 1699562249
Provider Name (Legal Business Name): DEMETRUS DEAN JONES PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24910 LAS BRISAS RD STE 117
MURRIETA CA
92562-4035
US

IV. Provider business mailing address

32157 KALE LN
WINCHESTER CA
92596-8794
US

V. Phone/Fax

Practice location:
  • Phone: 310-999-1201
  • Fax:
Mailing address:
  • Phone: 310-999-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95034830
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: