Provider Demographics
NPI:1083237440
Name:JONES, TIMEITSELF (MSN,BSN, APRN,FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:TIMEITSELF
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:MSN,BSN, APRN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 W ALONDRA BLVD # 14
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-3527
Mailing Address - Country:US
Mailing Address - Phone:310-567-3796
Mailing Address - Fax:
Practice Address - Street 1:850 W ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-3527
Practice Address - Country:US
Practice Address - Phone:310-567-3796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA850312163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty