Provider Demographics
NPI:1326805102
Name:JONES, BREANNA JONAY
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:JONAY
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 PAPAZIAN WAY
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4300
Mailing Address - Country:US
Mailing Address - Phone:510-869-9507
Mailing Address - Fax:
Practice Address - Street 1:4075 PAPAZIAN WAY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-4300
Practice Address - Country:US
Practice Address - Phone:510-869-9507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist