Provider Demographics
NPI:1255668539
Name:JONES, CAROL DIAN (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:DIAN
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GREY OWL
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-0312
Mailing Address - Country:US
Mailing Address - Phone:494-387-4905
Mailing Address - Fax:949-387-4079
Practice Address - Street 1:1601 AVOCADO AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7798
Practice Address - Country:US
Practice Address - Phone:949-387-4905
Practice Address - Fax:949-387-4079
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-07
Last Update Date:2009-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist