Provider Demographics
NPI:1740597053
Name:JONES, SOPHINA
Entity Type:Individual
Prefix:
First Name:SOPHINA
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 1:1947 CENTER ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1169
Mailing Address - Country:US
Mailing Address - Phone:510-981-5270
Mailing Address - Fax:510-981-5235
Practice Address - Street 1:3282 ADELINE ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2439
Practice Address - Country:US
Practice Address - Phone:510-981-5280
Practice Address - Fax:510-981-5255
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program