Provider Demographics
NPI:1518443720
Name:JONES, AMANDA (RBT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4059 CHESTNUT LN
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6735
Mailing Address - Country:US
Mailing Address - Phone:530-417-6456
Mailing Address - Fax:
Practice Address - Street 1:6000 J. STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-6073
Practice Address - Country:US
Practice Address - Phone:916-548-2562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-18-48713106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician