Provider Demographics
NPI:1598914541
Name:JONES, B. DEAN (MFT)
Entity Type:Individual
Prefix:
First Name:B. DEAN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 BENNETT VALLEY RD STE C210
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-5671
Mailing Address - Country:US
Mailing Address - Phone:707-545-9789
Mailing Address - Fax:707-545-9789
Practice Address - Street 1:2455 BENNETT VALLEY RD STE C210
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-5671
Practice Address - Country:US
Practice Address - Phone:707-545-9789
Practice Address - Fax:707-545-9789
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31558106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist