Provider Demographics
NPI:1699861716
Name:JONES, SUSAN VICTORIA (LICENSED MFT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:VICTORIA
Last Name:JONES
Suffix:
Gender:F
Credentials:LICENSED MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 LAZARRO DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923
Mailing Address - Country:US
Mailing Address - Phone:831-626-1753
Mailing Address - Fax:
Practice Address - Street 1:3533 LAZARRO DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923
Practice Address - Country:US
Practice Address - Phone:831-626-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT21536106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist