Provider Demographics
NPI:1881842920
Name:JONES-GARRETT, THERESE DALE (MFT)
Entity Type:Individual
Prefix:MS
First Name:THERESE
Middle Name:DALE
Last Name:JONES-GARRETT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:THERESE
Other - Middle Name:DJ
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:350 MILITARY WEST
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-3037
Mailing Address - Country:US
Mailing Address - Phone:707-746-1880
Mailing Address - Fax:707-745-1896
Practice Address - Street 1:1350 HAYES ST STE B3
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-2970
Practice Address - Country:US
Practice Address - Phone:707-746-1880
Practice Address - Fax:707-745-1896
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist