Provider Demographics
NPI:1376754853
Name:JONES, DONNA MARVA (NP-C, MA, MSN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARVA
Last Name:JONES
Suffix:
Gender:F
Credentials:NP-C, MA, MSN
Other - Prefix:MRS
Other - First Name:DONNA
Other - Middle Name:JONES
Other - Last Name:CREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4603 ANGELES VISTA BLVD
Mailing Address - Street 2:PO BOX 43781
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-1153
Mailing Address - Country:US
Mailing Address - Phone:323-298-9999
Mailing Address - Fax:
Practice Address - Street 1:16627 AVALON BLVD
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1008
Practice Address - Country:US
Practice Address - Phone:310-769-6797
Practice Address - Fax:310-769-1009
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN269945163WS0200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool