Provider Demographics
NPI:1750974564
Name:JONES, DAMONTE (BACHELORS, MPHC)
Entity type:Individual
Prefix:
First Name:DAMONTE
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:BACHELORS, MPHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 S KENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-5654
Mailing Address - Country:US
Mailing Address - Phone:213-291-7022
Mailing Address - Fax:
Practice Address - Street 1:234 S KENMORE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-5654
Practice Address - Country:US
Practice Address - Phone:213-291-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP000031544390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program