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NPI Code Detail

MEDICARE: MISS JESSE JOEL JONES

MEDICARE: MISS JESSE JOEL 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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1376724864
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JESSE JOEL JONES
Provider Business Mailing Address
First Line : 707 FAIR AVE
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-5828
Country : US
Telephone Number : 831-431-7323
Fax Number :
Provider Business Practice Location Address
First Line : 707 FAIR AVE
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-5828
Country : US
Telephone Number : 831-431-7323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2007
Last Update Date : 11/26/2007

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Directions to “ MISS JESSE JOEL JONES ” Practice Location

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