Provider Demographics
NPI:1518195809
Name:JONES, TRACY DIANE
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:DIANE
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 1:2401 E HOOVER AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-6116
Mailing Address - Country:US
Mailing Address - Phone:714-639-9305
Mailing Address - Fax:
Practice Address - Street 1:801 E. CHAPMAN AVE
Practice Address - Street 2:FLORENCE CRITTENTON SERVICES OF ORANGE COUNTY, INC
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3839
Practice Address - Country:US
Practice Address - Phone:714-680-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner