JENNA RENFROE (NPI# 1043682669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043682669 |
| Entity Type | Individual |
| Full Name | JENNA RENFROE |
| Other Name | JENA DIETZ |
| Credential | PHD |
| Practice Address |
8355 Merchants Gate Dr Jacksonville FL 32222-5848 |
| Mailing Address |
Po Box 44230 Jacksonville FL 32231-4230 |
| Practice Telephone | 9043763800 |
| Practice Fax Number | 9043907419 |
| Mailing Telephone | 9043763800 |
| Mailing Fax Number | 9043763998 |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2019-02-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY9563 | FL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 841 Prudential Dr, Tenth Floor, Jacksonville, FL 322078329 | 9043763800 | 9043968975 |
| Street Address |
8355 MERCHANTS GATE DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32222-5848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326483017 | Amy Melinda Hartley | Psychologist | 8355 Merchants Gate Dr, Jacksonville, FL 32222-5848 | 2013-05-08 |
| 1356883839 | Baptist Primary Care Inc | Family Medicine | 8355 Merchants Gate Dr, Jacksonville, FL 32222 | 2016-11-15 |
| 1669869681 | Crystal M Davis | Family Medicine | 8355 Merchants Gate Dr, Jacksonville, FL 32222 | 2015-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427690353 | Emergency Physicians Inc | Emergency Medicine | 9868 Family Place, Jacksonville, FL 32222 | 2019-10-11 |
| 1053874578 | Silver Linings Community Care, LLC. | Home Health Aide | 250 Cherry Ridge #1435, Jacksonville, FL 32222 | 2019-04-11 |
| 1588144802 | Fleming Total Support Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6760 Portofina Ct, Jacksonville, FL 32222 | 2018-08-16 |
| 1447736293 | Phyllis N Parrish | Home Health Aide | 10506 Innisbrook Dr, Jacksonville, FL 32222 | 2018-07-16 |
| 1851880793 | Keiarra Hendrick | Clinic/Center | 250 Cherry Ridge Dr Apt 1021, Jacksonville, FL 32222 | 2018-05-07 |
| 1427573310 | Priority Love & Care, Inc. | Voluntary or Charitable | 7283 Old Middleburg Rd S, Jacksonville, FL 32222 | 2017-08-11 |
| 1801334834 | Stacey Nicole Harden | Nurse Practitioner | 9785 Corsshill Blvd, Suite 108, Jacksonville, FL 32222 | 2017-02-09 |
| 1184031841 | Andrew Todd Pinder | Family Medicine | 8355 Merchants Gate Drive, Jacksonville, FL 32222 | 2014-07-15 |
| 1538455142 | Ricky Wallace | Social Worker | 10512 Innisbrook Drive, Jacksonville, FL 32222 | 2011-06-22 |
| 1477597680 | Kelly Lynne Broekhof | Registered Nurse | Bldg 2104 Massey Ave, Naval Station Mayport, Jacksonville, FL 32222 | 2006-06-16 |
| Find all providers in zip 32222 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447604806 | Rujvi Kamat | Clinical Neuropsychologist | 1235 San Marco Blvd Fl 4, Jacksonville, FL 32207-8554 | 2016-04-21 |
| 1750744405 | Andrew J Ruffett Phd LLC | Clinical Neuropsychologist | 11869 Curlew Way, Jacksonville, FL 32223-1939 | 2016-03-31 |
| 1629499819 | Bay Area Psychology Associates | Clinical Neuropsychologist | 302 Woodberry Pl, Jacksonville, NC 28540-4264 | 2013-12-14 |
| 1356778898 | Behavioral Health of North Florida Pllc | Clinical Neuropsychologist | 3733 University Blvd W Ste 214, Jacksonville, FL 32217-2128 | 2013-09-30 |
| 1093939498 | Christopher Rackley | Clinical Neuropsychologist | 1660 Prudential Dr Ste 210, Jacksonville, FL 32207-8185 | 2007-04-13 |
| 1336256353 | Elizabeth Tannahill Glen Keymer | Clinical Neuropsychologist | 751 Oak St Ste 120, Jacksonville, FL 32204-3359 | 2006-08-24 |
| 1215989991 | David S Sabsevitz | Clinical Neuropsychologist | 4500 San Pablo Rd S Dept Of, Jacksonville, FL 32224-1865 | 2006-05-17 |
| 1902880537 | Andrew J Ruffett | Clinical Neuropsychologist | 3617 Crown Point Rd, Ste 6, Jacksonville, FL 32257-9010 | 2005-12-06 |
| 1255331237 | Randi Most | Clinical Neuropsychologist | 13400 Sutton Park Dr S, Suite 1504, Jacksonville, FL 32224-0236 | 2005-07-30 |
| 1619973997 | Nicole Annette Hagedorn | Clinical Neuropsychologist | 2680 Henderson Dr Ste 5, Jacksonville, NC 28546-5297 | 2005-06-22 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32222 |
Please comment or provide details below to improve the information on JENNA RENFROE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.