Healthcare Provider Details

I. General information

NPI: 1568277887
Provider Name (Legal Business Name): JA' VANIA DENAI JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 E GILBERT ST
SAN BERNARDINO CA
92404-5413
US

IV. Provider business mailing address

780C E GILBERT ST
SAN BERNARDINO CA
92415-0001
US

V. Phone/Fax

Practice location:
  • Phone: 909-387-7377
  • Fax:
Mailing address:
  • Phone: 310-800-6690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: