Provider Demographics
NPI:1043435308
Name:JONES, WILLIAM HARLEY (PH D)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HARLEY
Last Name:JONES
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45175 PANORAMA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4482
Mailing Address - Country:US
Mailing Address - Phone:760-346-4665
Mailing Address - Fax:760-776-4073
Practice Address - Street 1:45175 PANORAMA DR
Practice Address - Street 2:SUITE B
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4482
Practice Address - Country:US
Practice Address - Phone:760-346-4665
Practice Address - Fax:760-776-4073
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 4910103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA953223293OtherFEDERAL TAX I.D. NUMBER
CA953223293OtherFEDERAL TAX I.D. NUMBER
CA00PL49100Medicare PIN