Provider Demographics
NPI:1609595800
Name:JONES, TELIA
Entity Type:Individual
Prefix:
First Name:TELIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 138TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2602
Mailing Address - Country:US
Mailing Address - Phone:510-693-7952
Mailing Address - Fax:
Practice Address - Street 1:700 ADELINE ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-2608
Practice Address - Country:US
Practice Address - Phone:510-835-9610
Practice Address - Fax:510-900-8830
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator