MEDICARE: KIMBERLY DIANE JONES PHD, PSY

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	103T00000X	Psychologist	PSY.0003974	CO

General Provider Information

NPI Number	:	1255611752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY DIANE JONES PHD, PSY

Provider Business Mailing Address
First Line	:	15215 CHELMSFORD ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-2506
Country	:	US
Telephone Number	:	719-203-1465
Fax Number	:

Provider Business Practice Location Address
First Line	:	15215 CHELMSFORD ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-2506
Country	:	US
Telephone Number	:	719-203-1465
Fax Number	:

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

Provider Enumeration Date	:	08/28/2011
Last Update Date	:	05/15/2024

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