Healthcare Provider Details

I. General information

NPI: 1861263725
Provider Name (Legal Business Name): AJA LIN JONES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 2ND ST STE D
SANTA MONICA CA
90401-2399
US

IV. Provider business mailing address

1417 2ND ST STE D
SANTA MONICA CA
90401-2399
US

V. Phone/Fax

Practice location:
  • Phone: 646-650-5337
  • Fax:
Mailing address:
  • Phone: 646-650-5337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1148946
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95029391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: