Provider Demographics
NPI:1477646610
Name:JONES-WICKS, YVONNE DOLORES (PA-C)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:DOLORES
Last Name:JONES-WICKS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 S ASPEN CT STE B
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5381
Mailing Address - Country:US
Mailing Address - Phone:559-334-6720
Mailing Address - Fax:559-429-8240
Practice Address - Street 1:137 S ASPEN CT STE B
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5381
Practice Address - Country:US
Practice Address - Phone:559-334-6720
Practice Address - Fax:559-429-8240
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004315363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ21447Medicare UPIN
GAQ21447Medicare UPIN