Provider Demographics
NPI:1992584916
Name:JONES, SENNITA
Entity type:Individual
Prefix:
First Name:SENNITA
Middle Name:
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 1:1406 W 75TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2960
Mailing Address - Country:US
Mailing Address - Phone:216-218-8997
Mailing Address - Fax:
Practice Address - Street 1:1406 W 75TH ST APT 1
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2960
Practice Address - Country:US
Practice Address - Phone:216-218-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2024-11-12
Deactivation Date:2024-03-22
Deactivation Code:
Reactivation Date:2024-11-12
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2910854Medicaid