Provider Demographics
NPI:1104043645
Name:JONES, MARY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2743
Mailing Address - Country:US
Mailing Address - Phone:415-922-7572
Mailing Address - Fax:
Practice Address - Street 1:5625 COLLEGE AVE
Practice Address - Street 2:SUITE 216-B
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1585
Practice Address - Country:US
Practice Address - Phone:415-244-9702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20176103TC0700X
FL6407103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical