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NPI Code Detail

MEDICARE: MYRA WYNTER JONES

MEDICARE: MYRA WYNTER JONES
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1245047166
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRA WYNTER JONES
Provider Business Mailing Address
First Line : 1200 CONCORD AVE STE 185
Second Line :
City : CONCORD
State : CA
Zip : 94520-5006
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4417 CORPORATION LN STE 300
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-3477
Country : US
Telephone Number : 757-785-3338
Fax Number : 757-785-3338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2024
Last Update Date : 05/29/2025

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