Provider Demographics
NPI:1053899252
Name:JONES, ALABUNMI AM (LCSW)
Entity type:Individual
Prefix:
First Name:ALABUNMI
Middle Name:AM
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MICHELLE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ASW
Mailing Address - Street 1:28649 S WESTERN AVE UNIT 6302
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90734-0128
Mailing Address - Country:US
Mailing Address - Phone:424-271-5149
Mailing Address - Fax:
Practice Address - Street 1:28649 S WESTERN AVE UNIT 6302
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90734-0128
Practice Address - Country:US
Practice Address - Phone:424-271-5149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA700721041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical