Provider Demographics
NPI:1871781351
Name:JONES, MARIA ANTOINETTE (CAS)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANTOINETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:ANTOINETTE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CAS
Mailing Address - Street 1:2049 SKYLINE DR
Mailing Address - Street 2:2049 SKYLINE DRIVE
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945-4221
Mailing Address - Country:US
Mailing Address - Phone:619-465-7303
Mailing Address - Fax:619-466-4672
Practice Address - Street 1:2049 SKYLINE DR
Practice Address - Street 2:2049 SKYLINE DRIVE
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-4221
Practice Address - Country:US
Practice Address - Phone:619-465-7303
Practice Address - Fax:619-466-4672
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID01-042317101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)