1689837494 NPI number — DR. JOAN WICKHAM JONES PSYD

Table of content: DR. JOAN WICKHAM JONES PSYD (NPI 1689837494)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689837494 NPI number — DR. JOAN WICKHAM JONES PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
JOAN
Provider Middle Name:
WICKHAM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689837494
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
141 W DAVIES AVE N
Provider Second Line Business Mailing Address:
STE 105
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80120-5211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-730-1717
Provider Business Mailing Address Fax Number:
303-730-1531

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
141 W DAVIES AVE N
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80120-5211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-730-1717
Provider Business Practice Location Address Fax Number:
303-730-1531
Provider Enumeration Date:
07/02/2008

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: 103TC1900X , with the licence number:  3048 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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