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NPI Code Detail

MEDICARE: ANDREW SEAN JONES MA, PH.D

MEDICARE: ANDREW SEAN JONES MA, PH.D
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
1103T00000XPsychologist103406NC
2103T00000XPsychologist1873SC
3103T00000XPsychologist4040TN
4103T00000XPsychologist13820914-2501UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113820914-2501OTHERUTLICENSE
2103406OTHERNCLICENSE

General Provider Information

NPI Number : 1922673136
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW SEAN JONES MA, PH.D
Provider Business Mailing Address
First Line : 16255 VENTURA BLVD STE 900
Second Line :
City : ENCINO
State : CA
Zip : 91436-2317
Country : US
Telephone Number : 801-935-4171
Fax Number : 704-838-1541
Provider Business Practice Location Address
First Line : 240 MORRIS AVE STE 100
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-3278
Country : US
Telephone Number : 801-823-1486
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2021
Last Update Date : 10/08/2024

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