Provider Demographics
NPI:1699158972
Name:JONES, MELISSA JANE (PHD, MSW)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:JANE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 E VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-3677
Mailing Address - Country:US
Mailing Address - Phone:707-495-4236
Mailing Address - Fax:855-975-2985
Practice Address - Street 1:3130 E VICTORIA DR
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-3677
Practice Address - Country:US
Practice Address - Phone:707-495-4236
Practice Address - Fax:855-975-2985
Is Sole Proprietor?:No
Enumeration Date:2015-07-03
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW66919104100000X
AZLCSW-185901041C0700X
UT14174915-35011041C0700X
CA1702167861041S0200X
CALCSW86368390200000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program