Individual provider Active NPI

Taylor Diane Materia, BCBA

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1154934545
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-78476 Issued in FL
Practice address
12735 Gran Bay Pkwy W Ste 204
Jacksonville, FL 32258-4499
Phone
(888) 754-0398
Fax
(954) 982-6491
NPI assigned
Aug 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-24-78476 FL Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

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

Mailing address

6416 NW 5TH Way
Fort Lauderdale, FL 33309-6112
Phone (888) 754-0398

Other names 1

  • Miss Taylor Diane Rentz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vocational Development Group, LLC Behavior Analyst CurrentSince Jan 4, 2026 Accepting new patients
Paper Airplane Behavioral Services PA Behavior Analyst Past Accepting new patients
Vocational Development Group, LLC Behavior Analyst PastSince Jan 4, 2026 Accepting new patients
Proactive Life Skills LLC PastSince Aug 1, 2020 Accepting new patients

Locations

12735 Gran Bay Pkwy W
Ste 204
Jacksonville, FL 32258
Phone (855) 290-8045

6416 NW 5th Way
Lauderdale Lakes, FL 33309
Phone (407) 489-2906

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1154934545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 NW 5TH WAY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333096112",
            "telephone_number": "888-754-0398",
            "fax_number": "954-982-6491"
        },
        {
            "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",
            "fax_number": "954-982-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATERIA",
        "first_name": "TAYLOR",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-24-78476",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "RENTZ",
            "middle_name": "DIANE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.