Provider Demographics
NPI:1124241286
Name:LEMON, JEFF JR
Entity type:Individual
Prefix:MR
First Name:JEFF
Middle Name:
Last Name:LEMON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 BAY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5260
Mailing Address - Country:US
Mailing Address - Phone:619-476-6246
Mailing Address - Fax:619-476-6392
Practice Address - Street 1:780 BAY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5260
Practice Address - Country:US
Practice Address - Phone:619-476-6246
Practice Address - Fax:619-476-6392
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker