Provider Demographics
NPI:1447451786
Name:JONES, SHAWNA MARIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SHAWNA
Other - Middle Name:MARIE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:11190 WARNER AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4019
Mailing Address - Country:US
Mailing Address - Phone:714-979-2401
Mailing Address - Fax:714-966-0837
Practice Address - Street 1:11190 WARNER AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4019
Practice Address - Country:US
Practice Address - Phone:714-979-2401
Practice Address - Fax:714-966-0837
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19234363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant