Provider Demographics
NPI:1790849511
Name:JONES, MELISSA LYNN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-0400
Mailing Address - Country:US
Mailing Address - Phone:530-527-5631
Mailing Address - Fax:
Practice Address - Street 1:1860 WALNUT ST
Practice Address - Street 2:STE. A
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3611
Practice Address - Country:US
Practice Address - Phone:530-527-5631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist