Basic Information
Provider Information
NPI: 1356549620
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: ESTHER
MiddleName: ELISABETH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5674 STONERIDGE DR
Address2: # 116
City: PLEASANTON
State: CA
PostalCode: 945888500
CountryCode: US
TelephoneNumber: 9255200005
FaxNumber: 9255200010
Practice Location
Address1: 411 30TH ST
Address2: # 314
City: OAKLAND
State: CA
PostalCode: 946093301
CountryCode: US
TelephoneNumber: 5102734200
FaxNumber: 5102738340
Other Information
ProviderEnumerationDate: 07/06/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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