Provider Demographics
NPI:1437461175
Name:JONES, HEATHER (OD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 CLEMENT ST # 112A
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1563
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:415-379-5590
Practice Address - Street 1:4150 CLEMENT ST # 112A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1563
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-379-5590
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT14105152W00000X
PAOEG002381152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No152W00000XEye and Vision Services ProvidersOptometrist