Provider Demographics
NPI:1063547230
Name:JONES, KRISTEN JEANNINE (MA)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:JEANNINE
Last Name:JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:JEANNINE
Other - Last Name:ORMSBEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:19401 S VERMONT AVE
Mailing Address - Street 2:STE A-200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1029
Mailing Address - Country:US
Mailing Address - Phone:310-323-6887
Mailing Address - Fax:310-323-1570
Practice Address - Street 1:19401 S VERMONT AVE
Practice Address - Street 2:STE A-200
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1029
Practice Address - Country:US
Practice Address - Phone:310-323-6887
Practice Address - Fax:310-323-1570
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 52024106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist