Provider Demographics
NPI:1427294784
Name:JONES, VENASHA ANTONEK
Entity type:Individual
Prefix:
First Name:VENASHA
Middle Name:ANTONEK
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 1:9029 JAMACHA RD APT 56
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-4174
Mailing Address - Country:US
Mailing Address - Phone:619-920-9799
Mailing Address - Fax:
Practice Address - Street 1:9029 JAMACHA RD APT 56
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-4174
Practice Address - Country:US
Practice Address - Phone:619-920-9799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN213661164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse