Healthcare Provider Details

I. General information

NPI: 1255723235
Provider Name (Legal Business Name): LIZA T. JONES LMFT, PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2015
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 CAMINO DEL RIO N STE 400
SAN DIEGO CA
92108-5724
US

IV. Provider business mailing address

PO BOX 40
POOLER GA
31322-0040
US

V. Phone/Fax

Practice location:
  • Phone: 619-350-1495
  • Fax: 858-790-8300
Mailing address:
  • Phone: 619-350-1495
  • Fax: 858-790-8300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1835-14
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number440
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number123282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: