MEDICARE: DR. JANICE ANNETTE JONES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084F0202X	Forensic Psychiatry Physician	A40698	CA
2	2084P0800X	Psychiatry Physician	A40698	CA
3	2084P0804X	Child & Adolescent Psychiatry Physician	A40698	CA

General Provider Information

NPI Number	:	1134292014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE ANNETTE JONES M.D.

Provider Business Mailing Address
First Line	:	2220 MOUNTAIN BLVD
Second Line	:	SUITE 240
City	:	OAKLAND
State	:	CA
Zip	:	94611-2905
Country	:	US
Telephone Number	:	510-482-8021
Fax Number	:	510-482-8022

Provider Business Practice Location Address
First Line	:	2220 MOUNTAIN BLVD
Second Line	:	SUITE 240
City	:	OAKLAND
State	:	CA
Zip	:	94611-2905
Country	:	US
Telephone Number	:	510-482-8021
Fax Number	:	510-482-8022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	08/05/2021

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