Provider Demographics
NPI:1912198409
Name:JONES, PAMELA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:JEAN
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:JEAN
Other - Last Name:FOWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:355 SANTA FE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5152
Mailing Address - Country:US
Mailing Address - Phone:760-707-6941
Mailing Address - Fax:866-496-4489
Practice Address - Street 1:1345 ENCINITAS BLVD # 432
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2845
Practice Address - Country:US
Practice Address - Phone:760-707-6941
Practice Address - Fax:866-496-4489
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG835142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F63216Medicare UPIN