Healthcare Provider Details

I. General information

NPI: 1447771787
Provider Name (Legal Business Name): JADE JONES APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5214F DIAMOND HEIGHTS BLVD
SAN FRANCISCO CA
94131-2175
US

IV. Provider business mailing address

4615 W LOUGHMAN ST
TAMPA FL
33616-1853
US

V. Phone/Fax

Practice location:
  • Phone: 415-360-3348
  • Fax:
Mailing address:
  • Phone: 708-466-1956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number33193
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209016107
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11007564
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2380065
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: