Provider Demographics
NPI:1841354289
Name:MARTIN JONES, LEE ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:LEE
Middle Name:ANN
Last Name:MARTIN JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LEE
Other - Middle Name:ANN
Other - Last Name:HOLLETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:900 VETERANS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1715
Mailing Address - Country:US
Mailing Address - Phone:650-299-4456
Mailing Address - Fax:650-299-4957
Practice Address - Street 1:900 VETERANS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1715
Practice Address - Country:US
Practice Address - Phone:650-299-4456
Practice Address - Fax:650-299-4957
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 14422171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS 14422OtherCALIFORNIA BOARD OF BEHAV