Provider Demographics
NPI:1437701596
Name:JONES, JAMIE D
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:D
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14400 NEWPORT AVE APT 51
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-5620
Mailing Address - Country:US
Mailing Address - Phone:949-331-6502
Mailing Address - Fax:
Practice Address - Street 1:14400 NEWPORT AVE APT 51
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-5620
Practice Address - Country:US
Practice Address - Phone:949-331-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer