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NPI Code Detail

MEDICARE: MRS. BONNIE BRYNN JONES LCSW

MEDICARE: MRS. BONNIE BRYNN 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 Worker94412CA

General Provider Information

NPI Number : 1801402151
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BONNIE BRYNN JONES LCSW
Provider Business Mailing Address
First Line : 9324 W STOCKTON BLVD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-8012
Country : US
Telephone Number : 916-478-7626
Fax Number :
Provider Business Practice Location Address
First Line : 4001 J ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95819-3600
Country : US
Telephone Number : 609-661-0951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2020
Last Update Date : 01/26/2022

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