Provider Demographics
NPI:1114610656
Name:JONES, MELANIE S (EDD, PSYD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:S
Last Name:JONES
Suffix:
Gender:F
Credentials:EDD, PSYD
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:JONES
Other - Last Name:OWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD, PSYD
Mailing Address - Street 1:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-0128
Mailing Address - Country:US
Mailing Address - Phone:907-215-5325
Mailing Address - Fax:
Practice Address - Street 1:5905 LAKE EARL DR
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95532-9715
Practice Address - Country:US
Practice Address - Phone:707-465-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94027308390200000X
CA94027308103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program