Provider Demographics
NPI:1821199845
Name:JONES, SHARON JEVETTA (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:JEVETTA
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 HILLTOP MALL RD 300
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-5274
Mailing Address - Country:US
Mailing Address - Phone:510-233-1990
Mailing Address - Fax:510-233-1896
Practice Address - Street 1:2970 HILLTOP MALL RD 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-5274
Practice Address - Country:US
Practice Address - Phone:510-233-1990
Practice Address - Fax:510-233-1896
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70338207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G703381Medicaid
110203925OtherRAILROAD MEDICARE
CA00G703381Medicaid
F41236Medicare UPIN