Provider Demographics
NPI:1427293455
Name:JONES, TRACEY LYNN (ASW)
Entity type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4564 CASA DEL SOL CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-4846
Mailing Address - Country:US
Mailing Address - Phone:619-651-0253
Mailing Address - Fax:
Practice Address - Street 1:4564 CASA DEL SOL CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-4846
Practice Address - Country:US
Practice Address - Phone:619-651-0253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 24487104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker