Healthcare Provider Details

I. General information

NPI: 1316332026
Provider Name (Legal Business Name): CARRIE JONES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CARRIE RICE D.O.

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BICENTENNIAL WAY
SANTA ROSA CA
95403-2149
US

IV. Provider business mailing address

401 BICENTENNIAL WAY
SANTA ROSA CA
95403-2149
US

V. Phone/Fax

Practice location:
  • Phone: 707-393-4000
  • Fax:
Mailing address:
  • Phone: 707-393-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number007792
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A22981
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number007792
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: