Provider Demographics
NPI:1710049473
Name:JONES, JOSCELYN CAROL (ESQ)
Entity Type:Individual
Prefix:MS
First Name:JOSCELYN
Middle Name:CAROL
Last Name:JONES
Suffix:
Gender:F
Credentials:ESQ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511M SYCAMORE AVE # 224
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-1706
Mailing Address - Country:US
Mailing Address - Phone:925-308-7953
Mailing Address - Fax:925-308-7953
Practice Address - Street 1:1511M SYCAMORE AVE # 224
Practice Address - Street 2:
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-1706
Practice Address - Country:US
Practice Address - Phone:925-308-7953
Practice Address - Fax:925-308-7953
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105807283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital