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NPI Code Detail

MEDICARE: MR. FRED JONAS

MEDICARE: MR. FRED JONAS
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) CounselorCAADACA3739499CA

General Provider Information

NPI Number : 1427015841
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FRED JONAS
Provider Business Mailing Address
First Line : 6127 FAIR OAKS BLVD
Second Line :
City : CARMICHAEL
State : CA
Zip : 95608
Country : US
Telephone Number : 916-974-8090
Fax Number : 916-974-7851
Provider Business Practice Location Address
First Line : 6127 FAIR OAKS BLVD
Second Line :
City : CARMICHAEL
State : CA
Zip : 95608-4818
Country : US
Telephone Number : 916-974-8090
Fax Number : 916-974-7851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 06/01/2016

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