Provider Demographics
NPI:1134292014
Name:JONES, JANICE ANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:ANNETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JANICE
Other - Middle Name:ANNETTE
Other - Last Name:MCKEOWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2220 MOUNTAIN BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2905
Mailing Address - Country:US
Mailing Address - Phone:510-482-8021
Mailing Address - Fax:510-482-8022
Practice Address - Street 1:2220 MOUNTAIN BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2905
Practice Address - Country:US
Practice Address - Phone:510-482-8021
Practice Address - Fax:510-482-8022
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA406982084F0202X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A4069800Medicare ID - Type UnspecifiedLICENCE