Provider Demographics
NPI:1730586793
Name:JONES, CHERYL NOEL (RN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:NOEL
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E HAZELTON AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95205-6229
Mailing Address - Country:US
Mailing Address - Phone:209-468-3822
Mailing Address - Fax:209-468-8222
Practice Address - Street 1:1601 E HAZELTON AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95205-6229
Practice Address - Country:US
Practice Address - Phone:209-468-3822
Practice Address - Fax:209-468-8222
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA631217163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse