Provider Demographics
NPI:1801789144
Name:JONES, HEATHER LEANN (CMT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEANN
Last Name:JONES
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7095 ORCHARD STATION RD
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-6253
Mailing Address - Country:US
Mailing Address - Phone:971-241-6966
Mailing Address - Fax:
Practice Address - Street 1:130 PETALUMA AVE STE 2F
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4234
Practice Address - Country:US
Practice Address - Phone:971-241-6966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99591225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist