Provider Demographics
NPI:1952842817
Name:JONES, LAZJONDA
Entity Type:Individual
Prefix:
First Name:LAZJONDA
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 1:6021 CANYON GAP DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-1626
Mailing Address - Country:US
Mailing Address - Phone:562-396-3950
Mailing Address - Fax:
Practice Address - Street 1:6021 CANYON GAP DR
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-1626
Practice Address - Country:US
Practice Address - Phone:562-396-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-12
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA95205618163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst