Provider Demographics
NPI:1396821708
Name:JONES, WENDY ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 BENNETT RD
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-5135
Mailing Address - Country:US
Mailing Address - Phone:805-210-0420
Mailing Address - Fax:
Practice Address - Street 1:2775 TAPO ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-0466
Practice Address - Country:US
Practice Address - Phone:805-210-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA216581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical