Provider Demographics
NPI:1013670819
Name:JONES, SHANIKA KATARA
Entity Type:Individual
Prefix:
First Name:SHANIKA
Middle Name:KATARA
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 1:5601 EDENFIELD RD APT 1214
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-9426
Mailing Address - Country:US
Mailing Address - Phone:912-484-6599
Mailing Address - Fax:
Practice Address - Street 1:3733 UNIVERSITY BLVD W STE 208
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2103
Practice Address - Country:US
Practice Address - Phone:888-984-2523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health