Provider Demographics
NPI:1003215674
Name:JONES, GRAHAM
Entity Type:Individual
Prefix:MR
First Name:GRAHAM
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-4900
Mailing Address - Country:US
Mailing Address - Phone:707-255-3719
Mailing Address - Fax:707-255-3715
Practice Address - Street 1:1100 LINCOLN AVE
Practice Address - Street 2:STE 180
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-4900
Practice Address - Country:US
Practice Address - Phone:707-257-9719
Practice Address - Fax:707-255-3715
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker