Active NPI
Amanda Victoria Nixon, PSYD
- Psychologist
- Jacksonville, FL
National Provider Identifier
1336078047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY13024
- Practice address
- 807 Childrens Way
Jacksonville, FL 32207-8426 - Phone
- (904) 697-3600
- Fax
- (904) 697-3927
- NPI assigned
- May 18, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY13024 | FL | Primary |
Addresses
Primary practice location
807 Childrens Way
Jacksonville, FL 32207-8426
Mailing address
10140 Centurion Pkwy N
Jacksonville, FL 32256-0532
Phone (904) 697-4100
Other names 1
- Amanda Victoria Shaleen
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY13024 | FL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779235200000",
"number": "1336078047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10140 CENTURION PKWY N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560532",
"telephone_number": "904-697-4100",
"fax_number": "904-697-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 CHILDRENS WAY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078426",
"telephone_number": "904-697-3600",
"fax_number": "904-697-3927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIXON",
"first_name": "AMANDA",
"middle_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-18",
"last_updated": "2026-05-20",
"certification_date": "2026-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY13024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "SHALEEN",
"middle_name": "VICTORIA",
"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 May 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.