Healthcare Provider Details

I. General information

NPI: 1104788025
Provider Name (Legal Business Name): EVELYN MARIE JONES CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1476 DELWOOD ST
VALLEJO CA
94591-5768
US

IV. Provider business mailing address

1476 DELWOOD ST
VALLEJO CA
94591-5768
US

V. Phone/Fax

Practice location:
  • Phone: 510-681-4129
  • Fax:
Mailing address:
  • Phone: 510-681-4129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number49896
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: