Provider Demographics
NPI:1629442058
Name:JONES, STORMEKA
Entity Type:Individual
Prefix:MS
First Name:STORMEKA
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 1:382 HARRIS RD
Mailing Address - Street 2:21
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-5354
Mailing Address - Country:US
Mailing Address - Phone:408-219-8457
Mailing Address - Fax:
Practice Address - Street 1:382 HARRIS RD
Practice Address - Street 2:21
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-5354
Practice Address - Country:US
Practice Address - Phone:408-219-8457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-15-05642103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst