Individual
DEITRA JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 E HACKETT RD, MODESTO, CA 95358-9001
(209) 525-7218
Mailing address
190 E HACKETT RD, MODESTO, CA 95358-9001
(209) 525-7218
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C030590115
CA
101YP2500X
Professional Counselor
Primary
ASW111251
CA
Other
Enumeration date
11/25/2013
Last updated
08/08/2024
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