Provider Demographics
NPI:1164737607
Name:JONES, DESIREE TATIANNA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:TATIANNA
Last Name:JONES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:TATIANNA
Other - Last Name:WEATHERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21263 ERWIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-3715
Mailing Address - Country:US
Mailing Address - Phone:888-515-3500
Mailing Address - Fax:
Practice Address - Street 1:21263 ERWIN ST
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-3715
Practice Address - Country:US
Practice Address - Phone:888-515-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63728106H00000X
CA78621106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist