Provider Demographics
NPI:1912095696
Name:JONES, MARTIN CALVIN JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:CALVIN
Last Name:JONES
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1529 E PALMDALE BLVD
Mailing Address - Street 2:SUITE#150
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-2034
Mailing Address - Country:US
Mailing Address - Phone:661-575-1800
Mailing Address - Fax:661-537-2932
Practice Address - Street 1:1529 E PALMDALE BLVD
Practice Address - Street 2:SUITE#150
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2034
Practice Address - Country:US
Practice Address - Phone:661-575-1800
Practice Address - Fax:661-537-2932
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA192331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical