Provider Demographics
NPI:1235259359
Name:JONES-KAZAN, DENISE LUCILLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:LUCILLE
Last Name:JONES-KAZAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:JONES-KAZAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:330 51ST STREET
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609
Mailing Address - Country:US
Mailing Address - Phone:510-254-1583
Mailing Address - Fax:570-528-9945
Practice Address - Street 1:6500 FAIRMOUNT AVE SUITE 9
Practice Address - Street 2:
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530
Practice Address - Country:US
Practice Address - Phone:510-254-1583
Practice Address - Fax:570-528-9945
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS18834104100000X
CA188341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical