Individual provider Active NPI

Daisy Yonzon Jones, DO

  • Pediatrics Physician
  • Tracy, CA
National Provider Identifier
1083671424
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A7375 Issued in CA
Practice address
2151 W Grant Line Rd
Tracy, CA 95377-7309
Phone
(209) 832-0535
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A7375 CA Primary

Addresses

Primary practice location

2151 W Grant Line Rd
Tracy, CA 95377-7309

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

Other identifiers 1

IdentifierTypeStateIssuer
00AX73750MedicaidCA

Other names 1

  • Daisy B Yonzon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701001590 CA Practitioner - Pediatric MedicinePractitioner - General Practice 7113904608 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7375CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Pediatrics CurrentSince Mar 1, 2016 Accepting new patients
Sutter Tracy Community Hospital Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1083671424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-524-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W GRANT LINE RD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777309",
            "telephone_number": "209-832-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "DAISY",
        "middle_name": "YONZON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A7375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX73750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAISY",
            "last_name": "YONZON",
            "middle_name": "B",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tracy, CA

Sources for this page

Verify at the official NPI Registry.