Provider Demographics
NPI:1629111471
Name:JONES, JEFF P (PHD)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:P
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 HIGHLAND DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2408
Mailing Address - Country:US
Mailing Address - Phone:858-793-4660
Mailing Address - Fax:
Practice Address - Street 1:990 HIGHLAND DR
Practice Address - Street 2:SUITE 103
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2408
Practice Address - Country:US
Practice Address - Phone:858-793-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 11466103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical