Provider Demographics
NPI:1215123849
Name:JONES, LA SONDRA KAY
Entity type:Individual
Prefix:MS
First Name:LA SONDRA
Middle Name:KAY
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 MT SILLIMAN WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-3019
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?:Yes
Enumeration Date:2007-09-18
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness