Provider Demographics
NPI:1285022871
Name:MELINDA MYERS PSYD INC
Entity Type:Organization
Organization Name:MELINDA MYERS PSYD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT, PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-825-1000
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22811103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty