Provider Demographics
NPI:1841679719
Name:JONES, MERRITT RENEE (LAC)
Entity type:Individual
Prefix:
First Name:MERRITT
Middle Name:RENEE
Last Name:JONES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 CAMINO DEL RIO S
Mailing Address - Street 2:#248
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3750
Mailing Address - Country:US
Mailing Address - Phone:619-512-9783
Mailing Address - Fax:
Practice Address - Street 1:2727 CAMINO DEL RIO S
Practice Address - Street 2:#248
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3750
Practice Address - Country:US
Practice Address - Phone:760-452-0987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16439171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist