Healthcare Provider Details

I. General information

NPI: 1871068460
Provider Name (Legal Business Name): JENNIFER L EVANS PSYD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W UNIVERSITY AVE STE 3
GAINESVILLE FL
32601-5205
US

IV. Provider business mailing address

204 W UNIVERSITY AVE STE 3
GAINESVILLE FL
32601-5205
US

V. Phone/Fax

Practice location:
  • Phone: 352-379-2829
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER L EVANS
Title or Position: MANAGER
Credential: PSYD
Phone: 352-405-5399