Provider Demographics
NPI:1326517426
Name:JONES, KATIE LYNN (LM)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40700 CALIFORNIA OAKS RD STE 108
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5789
Mailing Address - Country:US
Mailing Address - Phone:951-553-9804
Mailing Address - Fax:951-602-8181
Practice Address - Street 1:29664 WOODLANDS AVE
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6700
Practice Address - Country:US
Practice Address - Phone:951-553-9804
Practice Address - Fax:951-602-8181
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM546176B00000X
174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174N00000XOther Service ProvidersLactation Consultant, Non-RN