Provider Demographics
NPI:1922755487
Name:JONES, KEVIN MARIE
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:MARIE
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 1:1865 HOTEL CIR S
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3319
Mailing Address - Country:US
Mailing Address - Phone:619-204-6930
Mailing Address - Fax:
Practice Address - Street 1:1865 HOTEL CIR S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3319
Practice Address - Country:US
Practice Address - Phone:619-204-6930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist