Active NPI
Vonda Elizabeth Staten, PSYD
- School Psychologist
- Orange Park, FL
National Provider Identifier
1407619240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 1832
- Practice address
- 1050 Prairie Dunes CT
Orange Park, FL 32065-2679 - Phone
- (904) 708-7754
- NPI assigned
- Feb 5, 2024
- Last updated
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1832 | FL | Primary |
Addresses
Primary practice location
1050 Prairie Dunes CT
Orange Park, FL 32065-2679
Mailing address
1050 Prairie Dunes CT
Orange Park, FL 32065-2679
Phone (904) 708-7754
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 |
|---|---|---|---|
| 1832 | FL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1407619240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 PRAIRIE DUNES CT",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320652679",
"telephone_number": "904-708-7754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 PRAIRIE DUNES CT",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320652679",
"telephone_number": "904-708-7754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STATEN",
"first_name": "VONDA",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2024-02-05",
"certification_date": "2024-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "1832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.