Healthcare Provider Details

I. General information

NPI: 1891148953
Provider Name (Legal Business Name): JOLEE HIBBARD PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4626 DELWOOD VIEW BLVD
PANAMA CITY BEACH FL
32408-7107
US

IV. Provider business mailing address

4626 DELWOOD VIEW BLVD
PANAMA CITY BEACH FL
32408-7107
US

V. Phone/Fax

Practice location:
  • Phone: 949-373-3640
  • Fax:
Mailing address:
  • Phone: 949-374-0247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPY13097
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number40117
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number32479
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: