Provider Demographics
NPI:1811343775
Name:JONES-THOMAS, ANDRELLA VONTELLA
Entity type:Individual
Prefix:MRS
First Name:ANDRELLA
Middle Name:VONTELLA
Last Name:JONES-THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANDRELLA
Other - Middle Name:VONTELLA
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8824 LAGUNA STAR DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-6301
Mailing Address - Country:US
Mailing Address - Phone:916-709-1546
Mailing Address - Fax:
Practice Address - Street 1:8824 LAGUNA STAR DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-6301
Practice Address - Country:US
Practice Address - Phone:916-709-1546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor