Provider Demographics
NPI:1659620219
Name:JONES, BRENDA
Entity Type:Individual
Prefix:
First Name:BRENDA
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 1:600 E 7TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-1439
Mailing Address - Country:US
Mailing Address - Phone:213-537-0110
Mailing Address - Fax:213-537-0880
Practice Address - Street 1:600 E 7TH ST STE 105
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1439
Practice Address - Country:US
Practice Address - Phone:213-537-0110
Practice Address - Fax:213-537-0880
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor