Jones, Jerry Travis

Jones, Jerry Travis is an individual health care provider with primary practice located at 2522 Grand Canal Blvd #1, Stockton CA 95207-8213. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Jones, Jerry Travis can be contacted via phone (209) 951-4666.

Contact Information

Primary practice address
2522 Grand Canal Blvd #1 Stockton CA 95207-8213
Phone: (209) 951-4666
Fax: (209) 951-5829
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A23838 California

Profile Details

NPI number 1144330572
LBN Legal business name Jones, Jerry Travis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144330572 NPPES
California MEDICAID 00A238380

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