Provider Demographics
NPI:1962816975
Name:JONES, VELISIA
Entity Type:Individual
Prefix:
First Name:VELISIA
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 1:1675 7TH ST
Mailing Address - Street 2:24753
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94623-6099
Mailing Address - Country:US
Mailing Address - Phone:510-575-9355
Mailing Address - Fax:
Practice Address - Street 1:1675 7TH ST
Practice Address - Street 2:24753
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94623-6099
Practice Address - Country:US
Practice Address - Phone:510-575-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program