Provider Demographics
NPI:1215123849
Name:JONES, LASONDRA KAY (ADMINISTRATOR, SOCIA)
Entity type:Individual
Prefix:MS
First Name:LASONDRA
Middle Name:KAY
Last Name:JONES
Suffix:
Gender:F
Credentials:ADMINISTRATOR, SOCIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2514 CARMEL ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3015
Mailing Address - Country:US
Mailing Address - Phone:510-772-0442
Mailing Address - Fax:510-482-0114
Practice Address - Street 1:1710 MT SILLIMAN WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-3019
Practice Address - Country:US
Practice Address - Phone:510-772-0442
Practice Address - Fax:510-482-0114
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children