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General NPI Number Information
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NPI Number | 1265236020
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Entity Type | Organization
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Legal Business Name | PATTERSON BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 90 FORT WADE RD STE 100
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City | PONTE VEDRA
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State | FL
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Zip | 32081-5114
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Country | US
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Telephone | 904-351-6342
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Fax |
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Provider Business Mailing Address
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Address Line | 10700 BEACH BLVD UNIT 17254
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City | JACKSONVILLE
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State | FL
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Zip | 32245-8051
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Country | US
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Telephone | 904-351-6342
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DE'VON PATTERSON
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Credential | PHD
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Telephone | 904-351-6342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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