Healthcare Provider Details

I. General information

NPI: 1609318781
Provider Name (Legal Business Name): CHERISE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 CASTLE HILL CT APT 56
SACRAMENTO CA
95821-5810
US

IV. Provider business mailing address

2045 W EL CAMINO AVE APT 377
SACRAMENTO CA
95833-2954
US

V. Phone/Fax

Practice location:
  • Phone: 415-730-1508
  • Fax:
Mailing address:
  • Phone: 415-730-1508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: