Provider Demographics
NPI:1710547773
Name:JONES, STEPHANIE M
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:M
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 1:200 S 3RD ST UNIT 720392
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95172-3016
Mailing Address - Country:US
Mailing Address - Phone:408-780-0428
Mailing Address - Fax:
Practice Address - Street 1:2 EDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-1841
Practice Address - Country:US
Practice Address - Phone:562-400-5997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health