Provider Demographics
NPI:1699562249
Name:JONES, DEMETRUS DEAN (PMHNP)
Entity type:Individual
Prefix:MR
First Name:DEMETRUS
Middle Name:DEAN
Last Name:JONES
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32157 KALE LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8794
Mailing Address - Country:US
Mailing Address - Phone:310-999-1201
Mailing Address - Fax:
Practice Address - Street 1:32157 KALE LN
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-8794
Practice Address - Country:US
Practice Address - Phone:310-999-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034830363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health