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NPI Code Detail

MEDICARE: MS. PHELICIA JONES

MEDICARE: MS. PHELICIA 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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1316169436
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PHELICIA JONES
Provider Business Mailing Address
First Line : 1919 ALAMEDA DE LAS PULGAS
Second Line : APT # 149
City : SAN MATEO
State : CA
Zip : 94403-1266
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2261 BRYANT ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94110-2833
Country : US
Telephone Number : 415-206-1560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 07/08/2007

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