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General NPI Number Information
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NPI Number | 1669046793
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Entity Type | Individual
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Provider Name | DR. ATHENA JANEE JONES
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Gender | Female
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 940 S COAST DR STE 225
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City | COSTA MESA
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State | CA
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Zip | 92626-7757
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Country | US
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Telephone | 949-743-1457
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Fax |
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Provider Business Mailing Address
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Address Line | 688 13TH ST APT 245
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City | SAN DIEGO
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State | CA
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Zip | 92101-7394
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Country | US
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Telephone | 619-929-8603
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35208
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License Number State | CA
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