Provider Demographics
NPI:1962679449
Name:EMERY-JONES, JOLLENE D (PT)
Entity Type:Individual
Prefix:
First Name:JOLLENE
Middle Name:D
Last Name:EMERY-JONES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11631 REDWING CT
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95946-9662
Mailing Address - Country:US
Mailing Address - Phone:530-432-9635
Mailing Address - Fax:
Practice Address - Street 1:11631 REDWING CT
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95946-9662
Practice Address - Country:US
Practice Address - Phone:530-432-9635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist