Healthcare Provider Details

I. General information

NPI: 1063096907
Provider Name (Legal Business Name): DR. ERYN DAPHNE JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9912 CARMEL MOUNTAIN RD STE B
SAN DIEGO CA
92129-2808
US

IV. Provider business mailing address

2941 VIA VIEJAS OESTE
ALPINE CA
91901-3171
US

V. Phone/Fax

Practice location:
  • Phone: 858-538-9182
  • Fax:
Mailing address:
  • Phone: 956-867-1520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number107507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: