MEDICARE: DR. JAY JEFFREY 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
1	1041C0700X	Clinical Social Worker	LCS9812	CA

General Provider Information

NPI Number	:	1841483294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY JEFFREY JONES LCSW

Provider Business Mailing Address
First Line	:	PO BOX 963
Second Line	:
City	:	SUN CITY
State	:	CA
Zip	:	92586-0963
Country	:	US
Telephone Number	:	951-848-9439
Fax Number	:	951-848-9439

Provider Business Practice Location Address
First Line	:	28834 PORTSMOUTH DR
Second Line	:
City	:	SUN CITY
State	:	CA
Zip	:	92586-2624
Country	:	US
Telephone Number	:	951-848-9439
Fax Number	:	951-848-9439

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

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	08/20/2007

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