Provider Demographics
NPI:1518339365
Name:JONES, PIPPI
Entity Type:Individual
Prefix:
First Name:PIPPI
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATREA
Other - Middle Name:MANCUSO
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2015 PIONEER CT
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1781
Mailing Address - Country:US
Mailing Address - Phone:415-235-8254
Mailing Address - Fax:650-638-1602
Practice Address - Street 1:2015 PIONEER CT
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1781
Practice Address - Country:US
Practice Address - Phone:415-235-8254
Practice Address - Fax:650-638-1602
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)