Provider Demographics
NPI:1699977538
Name:JONES, CHARLES FREDRICK (MFT)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:FREDRICK
Last Name:JONES
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:MR
Other - First Name:CASS
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:221 S. EUCLID AVE.
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101
Mailing Address - Country:US
Mailing Address - Phone:626-578-9565
Mailing Address - Fax:
Practice Address - Street 1:221 S. EUCLID AVE.
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101
Practice Address - Country:US
Practice Address - Phone:626-578-9565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37897106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist