MEDICARE: MS. COURTNEY 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
1	175T00000X	Peer Specialist		CA

General Provider Information

NPI Number	:	1700503430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. COURTNEY JONES

Provider Business Mailing Address
First Line	:	2400 SHADY WILLOW LN UNIT 16A
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-3718
Country	:	US
Telephone Number	:	510-798-6538
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 SHADY WILLOW LN UNIT 16A
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-3718
Country	:	US
Telephone Number	:	510-798-6538
Fax Number	:

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

Provider Enumeration Date	:	10/24/2022
Last Update Date	:	05/29/2026

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