Provider Demographics
NPI:1629194519
Name:JONES, DENISE RENEE (PHD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:RENEE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 HOWARD ST FL 5
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2652
Mailing Address - Country:US
Mailing Address - Phone:415-255-3403
Mailing Address - Fax:415-255-3567
Practice Address - Street 1:1380 HOWARD ST FL 5
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2652
Practice Address - Country:US
Practice Address - Phone:415-255-3403
Practice Address - Fax:415-255-3567
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12950103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11197OtherSFGH INTERNAL USE ONLY
11197OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER