Provider Demographics
NPI:1407148943
Name:JONES, ILISTEN MARIE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ILISTEN
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:370 N WIGET LN
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2488
Mailing Address - Country:US
Mailing Address - Phone:925-935-6252
Mailing Address - Fax:925-930-0942
Practice Address - Street 1:370 N WIGET LN
Practice Address - Street 2:SUITE 210
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2488
Practice Address - Country:US
Practice Address - Phone:925-935-6252
Practice Address - Fax:925-930-0942
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA125510207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology