Provider Demographics
NPI:1043841562
Name:JONES, EVELYN (ACSW)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 S FIGUEROA ST # 707
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-2049
Mailing Address - Country:US
Mailing Address - Phone:424-302-3408
Mailing Address - Fax:
Practice Address - Street 1:555 E. HARDY STREET
Practice Address - Street 2:INGLEWOOD
Practice Address - City:CA
Practice Address - State:CA
Practice Address - Zip Code:90301
Practice Address - Country:US
Practice Address - Phone:310-695-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA739801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical