Provider Demographics
NPI:1578112249
Name:JONES, GEORGINA (RADT)
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34750 EAGER RD
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:CA
Mailing Address - Zip Code:93510-1136
Mailing Address - Country:US
Mailing Address - Phone:949-306-5445
Mailing Address - Fax:
Practice Address - Street 1:34750 EAGER RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:CA
Practice Address - Zip Code:93510-1136
Practice Address - Country:US
Practice Address - Phone:949-306-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)