1376754853 NPI number — MS. DONNA MARVA JONES NP-C, MA, MSN

Table of content: MS. DONNA MARVA JONES NP-C, MA, MSN (NPI 1376754853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376754853 NPI number — MS. DONNA MARVA JONES NP-C, MA, MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
DONNA
Provider Middle Name:
MARVA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NP-C, MA, MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CREER
Provider Other First Name:
DONNA
Provider Other Middle Name:
JONES
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376754853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4603 ANGELES VISTA BLVD
Provider Second Line Business Mailing Address:
PO BOX 43781
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90043-1153
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-298-9999
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16627 AVALON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARSON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90746-1008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-769-6797
Provider Business Practice Location Address Fax Number:
310-769-1009
Provider Enumeration Date:
05/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WS0200X , with the licence number:  RN269945 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: RN269945 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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