Provider Demographics
NPI:1578139614
Name:JONES, CRISTAL (MCHES)
Entity Type:Individual
Prefix:MS
First Name:CRISTAL
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MCHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18336 SOLEDAD CANYON RD 1752
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-4237
Mailing Address - Country:US
Mailing Address - Phone:323-646-2029
Mailing Address - Fax:
Practice Address - Street 1:18336 SOLEDAD CANYON RD # 1752
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-3035
Practice Address - Country:US
Practice Address - Phone:818-457-9522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-30
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
22931174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator