Sherry Lynn Patchan, RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

RBT-20-130489 Issued in FL

Practice address

12735 Gran Bay Pkwy W Ste 204
Jacksonville, FL 32258-4499

Phone

(888) 754-0398

NPI assigned

Jan 2, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Sherry Lynn Wolf Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1134832504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 SPRINGHEALTH CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320922460",
            "telephone_number": "904-347-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12735 GRAN BAY PKWY W STE 204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322584499",
            "telephone_number": "888-754-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATCHAN",
        "first_name": "SHERRY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-02",
        "last_updated": "2023-01-02",
        "certification_date": "2022-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "RBT-20-130489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRY",
            "last_name": "WOLF",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "N/A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Micah Pastula
• Deepak Kumar Pasupula, MD, MPH
• Edith Liliana Patarroyo Rodriguez, MD
• Gene R Patch, DMD
• Michael Edward Patch, D.D.S.
• Antonio Pate
• Brittney Morgan Price Pate, LMHC
• Christie L Pate, LMHC
• Heather Shanendoah Pate
• Julia Pate, PHARM.D

• Behavior Analyst in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.