Provider Demographics
NPI:1811593585
Name:JONES, JESSE CAMERON
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:CAMERON
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 710755
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92171-0755
Mailing Address - Country:US
Mailing Address - Phone:805-223-1841
Mailing Address - Fax:
Practice Address - Street 1:3914 MURPHY CANYON RD STE A201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4423
Practice Address - Country:US
Practice Address - Phone:619-988-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health