Provider Demographics
NPI:1285641795
Name:JONES, ALICE IZARD (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:IZARD
Last Name:JONES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8655 MORRO RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-3913
Mailing Address - Country:US
Mailing Address - Phone:805-466-1480
Mailing Address - Fax:
Practice Address - Street 1:8655 MORRO RD
Practice Address - Street 2:SUITE C
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-3913
Practice Address - Country:US
Practice Address - Phone:805-466-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37328106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist