Provider Demographics
NPI:1508117730
Name:JONES, KARYN MICHELLE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:MICHELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:MICHELLE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:8022 CRESTA BELLA RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-2787
Mailing Address - Country:US
Mailing Address - Phone:909-660-3020
Mailing Address - Fax:
Practice Address - Street 1:250 W 1ST ST STE 214
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4743
Practice Address - Country:US
Practice Address - Phone:909-660-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT52193106H00000X
CAMFC 52193106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist