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Jesse Jones, RADT-1R9201214
Substance Abuse Rehabilitation Facility in Novato, California
NPI 1356715098

Jesse Jones is a Substance Abuse Rehabilitation Facility based in Novato, CA. Jesse Jones practices in Novato, CA and has the professional credentials of RADT-1R9201214. The NPI Number for Jesse Jones is 1356715098 and holds a License No. R9201214 (California).

The current practice location address for Jesse Jones is 530 Loleta Ln, Novato, CA and can be reached out via phone at 415-678-6646.

Location: 530 Loleta Ln, Novato, CA, 94947-5210
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356715098
Provider Name
Jesse Jones
Credential
RADT-1R9201214
Provider Entity Type
Individual
Gender
Male
Address
530 Loleta Ln, Novato, CA, 94947-5210
Phone Number
415-678-6646
Fax Number
Provider Enumeration Date
11/18/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
D3861759 05 CA
institution
Provider Business Practice Location Address Details
Address
530 Loleta Ln
City
Novato
State
California
Zip
94947-5210
Phone Number
415-678-6646
Fax Number
person
Provider Business Mailing Address Details
Address
530 Loleta Ln
City
Novato
State
California
Zip
94947-5210
Phone Number
415-678-6646
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
R9201214 (California)
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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