Provider Demographics
NPI:1346353638
Name:JONES, DELBERT III (MS)
Entity Type:Individual
Prefix:
First Name:DELBERT
Middle Name:
Last Name:JONES
Suffix:III
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:DJ
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2727 DEL RIO PL
Mailing Address - Street 2:SUITE C
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-7729
Mailing Address - Country:US
Mailing Address - Phone:530-204-8588
Mailing Address - Fax:
Practice Address - Street 1:2727 DEL RIO PL
Practice Address - Street 2:SUITE C
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-7729
Practice Address - Country:US
Practice Address - Phone:530-204-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47860106H00000X
CAMFC44727106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000008462OtherMEDI CAL PROVIDER NUMBER