Provider Demographics
NPI:1902557291
Name:JONES, MAYA AMANDA
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:AMANDA
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 1:1529 THISTLE CT
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-2642
Mailing Address - Country:US
Mailing Address - Phone:925-752-5683
Mailing Address - Fax:
Practice Address - Street 1:1529 THISTLE CT
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-2642
Practice Address - Country:US
Practice Address - Phone:925-752-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician