Provider Demographics
NPI:1912405952
Name:JONES, SANDRA DENISE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:DENISE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2369 11TH ST NW APT 22
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2238
Mailing Address - Country:US
Mailing Address - Phone:202-847-7735
Mailing Address - Fax:202-388-4320
Practice Address - Street 1:2369 11TH ST NW APT 22
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2238
Practice Address - Country:US
Practice Address - Phone:202-847-7735
Practice Address - Fax:202-388-4320
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA13351374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide