Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 207816 | NY |
NPI | 1023114733 |
---|---|
Provider Name | Carri A Jones |
First Address | Daly City, CA 94015-2204 |
Second Address | Daly City, CA 94015-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 20/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G52678 | (02) | NY |