Xiao Dan Zeng, PSY.D.
Individual provider Active NPI Clinical Psychologist · Patrick Afb, FL
NPI 1760029987 · NPPES record last updated Feb 6, 2020
Key facts
- NPI
- 1760029987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY10302 (FL)
- Practice address
- 1381 S Patrick Dr
Patrick Afb, FL 32925-3606 - Phone
- (321) 494-8234
- NPI assigned
- Dec 6, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY10302 | FL | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY10302 | FL | Yes |
Addresses
Primary practice location
1381 S Patrick Dr
Patrick Afb, FL 32925-3606
Mailing address
1381 S Patrick Dr
Patrick Air Force Base, FL 32925-3606
Phone (321) 494-8234
Other providers in Patrick Afb, FL
- Wayland M Watts III
- Dawn L Werner
- Marie Wilson-Marshall
- Amber Shalise Wofford
- Maria Del Pilar Woods
- John E Zurasky
All providers in Patrick Afb, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.