Provider Demographics
NPI:1417769621
Name:JONES, ERICA ANGELIQUE
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ANGELIQUE
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 1:4037 GRANT HILL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6648
Mailing Address - Country:US
Mailing Address - Phone:702-533-6206
Mailing Address - Fax:
Practice Address - Street 1:6545 S FORT APACHE RD STE 135-105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-6752
Practice Address - Country:US
Practice Address - Phone:702-203-1964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner