Provider Demographics
NPI:1295214195
Name:JONES, WENDY PENDEXTER (LEP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:PENDEXTER
Last Name:JONES
Suffix:
Gender:F
Credentials:LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25527 LANGSTON ST
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2525
Mailing Address - Country:US
Mailing Address - Phone:661-755-2628
Mailing Address - Fax:
Practice Address - Street 1:27801 DICKASON DR
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4012
Practice Address - Country:US
Practice Address - Phone:661-294-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2818103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool