Provider Demographics
NPI:1457843955
Name:JONES, MARY JANE (RNP, MN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JANE
Last Name:JONES
Suffix:
Gender:F
Credentials:RNP, MN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4667 TELEGRAPH ROAD
Mailing Address - Street 2:STUDENT HEALTH CENTER
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003
Mailing Address - Country:US
Mailing Address - Phone:805-289-6346
Mailing Address - Fax:805-289-6098
Practice Address - Street 1:4667 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-289-6346
Practice Address - Fax:805-289-6098
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4054363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner