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NPI Code Detail

MEDICARE: MR. MICHAEL ANTHONY JONES LCSW

MEDICARE: MR. MICHAEL ANTHONY JONES LCSW
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
11041C0700XClinical Social WorkerLCSW22452CA

General Provider Information

NPI Number : 1548205719
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL ANTHONY JONES LCSW
Provider Business Mailing Address
First Line : 3511 CAMINO DEL RIO S STE 500
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4022
Country : US
Telephone Number : 619-297-0010
Fax Number :
Provider Business Practice Location Address
First Line : 3511 CAMINO DEL RIO S STE 500
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4022
Country : US
Telephone Number : 619-297-0010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 07/01/2024

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