Provider Demographics
NPI:1538214697
Name:JONES, RYLLE (MFT)
Entity type:Individual
Prefix:MS
First Name:RYLLE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 713
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:CA
Mailing Address - Zip Code:94517-0713
Mailing Address - Country:US
Mailing Address - Phone:925-695-3109
Mailing Address - Fax:
Practice Address - Street 1:600 W 3RD ST
Practice Address - Street 2:SUITE E
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1292
Practice Address - Country:US
Practice Address - Phone:925-695-3109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37293106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist