Provider Demographics
NPI:1619325552
Name:JONES, JUDITH SEBA (MFT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:SEBA
Last Name:JONES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:SEBA
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:1641 HOPKINS ST/
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2712
Mailing Address - Country:US
Mailing Address - Phone:510-525-2614
Mailing Address - Fax:
Practice Address - Street 1:1641 HOPKINS ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2712
Practice Address - Country:US
Practice Address - Phone:510-525-2614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25599106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist