Individual
SERENA ALICIA JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W HOSPITAL RD, FRENCH CAMP, CA 95231-9693
(209) 468-6013
Mailing address
500 W HOSPITAL RD, FRENCH CAMP, CA 95231-9693
(209) 468-6013
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
390002EN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3245S0500X
SUBSTANCE ABUSE
CA
Enumeration date
06/05/2019
Last updated
06/05/2019
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