Healthcare Provider Details

I. General information

NPI: 1164341541
Provider Name (Legal Business Name): MR. JOHN JOSE JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 S GARDEN ST
VISALIA CA
93277-4949
US

IV. Provider business mailing address

1627 S GARDEN ST
VISALIA CA
93277-4949
US

V. Phone/Fax

Practice location:
  • Phone: 559-908-0724
  • Fax:
Mailing address:
  • Phone: 559-908-0724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: