Individual
LONI D JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
815 COURT ST STE 7, JACKSON, CA 95642-2154
(209) 257-5900
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A132204
CA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
A132204
CA
Other
Enumeration date
04/15/2013
Last updated
01/14/2021
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