Provider Demographics
NPI:1477258481
Name:JONES, MAEGAN MARLENA (ACSW)
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:MARLENA
Last Name:JONES
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7052 SANTA TERESA BLVD # 1076
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95139-1348
Mailing Address - Country:US
Mailing Address - Phone:925-878-1117
Mailing Address - Fax:
Practice Address - Street 1:500 CARR 177 UNIT S1106
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-8913
Practice Address - Country:US
Practice Address - Phone:925-878-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1143761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical