Individual provider Active NPI

Pamela Jean Jones, M.D.

  • Psychiatry Physician
  • Encinitas, CA
National Provider Identifier
1912198409
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G83514 Issued in CA
Practice address
1345 Encinitas Blvd # 432
Encinitas, CA 92024-2845
Phone
(760) 707-6941
Fax
(866) 496-4489
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G83514 CA Primary

Addresses

Primary practice location

1345 Encinitas Blvd # 432
Encinitas, CA 92024-2845

Mailing address

355 Santa Fe Dr
Suite 200
Encinitas, CA 92024-5152
Phone (760) 707-6941

Other names 1

  • Pamela Jean Fowler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081203000350 CA Practitioner - Psychiatry 2668533126 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83514CAMDClinical Social Worker
G83514CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Exodus Recovery Inc Current Accepting new patients
Exodus Recovery, Inc. CurrentSince Sep 25, 2016 Accepting new patients
Exodus Recovery, Inc. CurrentSince Sep 25, 2016 Accepting new patients

Locations

9808 Venice Blvd
Ste 700
Culver City, CA 90232
Phone (310) 253-9494

4308 30th St
San Diego, CA 92104

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1912198409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 SANTA FE DR",
            "address_2": "SUITE 200",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245152",
            "telephone_number": "760-707-6941",
            "fax_number": "866-496-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 ENCINITAS BLVD # 432",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242845",
            "telephone_number": "760-707-6941",
            "fax_number": "866-496-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G83514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "FOWLER",
            "middle_name": "JEAN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.