Healthcare Provider Details

I. General information

NPI: 1144752734
Provider Name (Legal Business Name): JESSIE W ZHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESS ZHANG

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 MAPLE AVENUE PENN HIGHLANDS DUBOIS BEHAVIORAL HEALTH CENTER
DU BOIS PA
15801-1440
US

IV. Provider business mailing address

635 MAPLE AVE
DUBOIS PA
15801-2311
US

V. Phone/Fax

Practice location:
  • Phone: 814-375-6379
  • Fax: 814-375-9320
Mailing address:
  • Phone: 814-375-6379
  • Fax: 814-375-9320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD482651
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMT224592
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMT224593
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: