Provider Demographics
NPI:1982762647
Name:JONES, JEAN LORENE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:LORENE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:JEAN
Other - Middle Name:LORENE
Other - Last Name:REILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12880 MAGNOLIA AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-4572
Mailing Address - Country:US
Mailing Address - Phone:949-514-4155
Mailing Address - Fax:
Practice Address - Street 1:6101 BALL RD STE 304
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-3966
Practice Address - Country:US
Practice Address - Phone:562-431-8822
Practice Address - Fax:562-429-0384
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 173101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical