Provider Demographics
NPI:1700117769
Name:JONES, RAYANNA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:RAYANNA
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RAYANNA
Other - Middle Name:MARIE
Other - Last Name:LAUXDPT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 REVAS LNDG
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-7532
Mailing Address - Country:US
Mailing Address - Phone:530-559-6824
Mailing Address - Fax:
Practice Address - Street 1:1650 LEAD HILL BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3072
Practice Address - Country:US
Practice Address - Phone:916-677-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36330225100000X
TN13968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT463ZMedicare UPIN