Provider Demographics
NPI:1548498215
Name:MYERS, MELINDA (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 F ST STE B
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6364
Mailing Address - Country:US
Mailing Address - Phone:707-825-1000
Mailing Address - Fax:707-825-1000
Practice Address - Street 1:665 F ST STE B
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6364
Practice Address - Country:US
Practice Address - Phone:707-825-1000
Practice Address - Fax:707-825-1000
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22811103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist