Provider Demographics
NPI:1396366928
Name:JONES, NATASHA (MFT & PCC)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MFT & PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 RIDGELINE DR # J-202
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-8762
Mailing Address - Country:US
Mailing Address - Phone:714-612-1146
Mailing Address - Fax:
Practice Address - Street 1:1460 E HOLT AVE STE 182
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-5853
Practice Address - Country:US
Practice Address - Phone:909-620-0912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist