Provider Demographics
NPI:1164645958
Name:JONES, MAISHA E (RN, MSN, FNP, BC)
Entity Type:Individual
Prefix:MRS
First Name:MAISHA
Middle Name:E
Last Name:JONES
Suffix:
Gender:F
Credentials:RN, MSN, FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 PIANTINO CIR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4736
Mailing Address - Country:US
Mailing Address - Phone:619-847-8785
Mailing Address - Fax:
Practice Address - Street 1:220 EUCLID AVE STE 30
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-3617
Practice Address - Country:US
Practice Address - Phone:888-743-7526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABJ440ZMedicare UPIN