Provider Demographics
NPI:1992019632
Name:JONES, CLARENCE JERMON JR
Entity Type:Individual
Prefix:
First Name:CLARENCE
Middle Name:JERMON
Last Name:JONES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2592 PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2156
Mailing Address - Country:US
Mailing Address - Phone:408-781-0525
Mailing Address - Fax:
Practice Address - Street 1:2592 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2156
Practice Address - Country:US
Practice Address - Phone:408-781-0525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor