Fred J. Rahaim, PH.D. P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00002524 Issued in FL

Legal business name

FRED J. RAHAIM, PH.D. P.A.

Practice address

5635 Crest Creek Dr
Jacksonville, FL 32258-5358

Phone

(904) 704-0851

Fax

(904) 880-0652

NPI assigned

Sep 24, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Fred Joseph Rahaim, PH.,D.

Title

Licensed Psychologist

Phone

(904) 704-0851

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1972939767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 CREST CREEK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585358",
            "telephone_number": "904-704-0851",
            "fax_number": "904-880-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 CREST CREEK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585358",
            "telephone_number": "904-704-0851",
            "fax_number": "904-880-0652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED J. RAHAIM, PH.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "RAHAIM",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "904-704-0851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.,D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY00002524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1265475412",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenya Cheyenne Frazier
• Lori Lynn Frazier, M. A., LMHC
• Nada Lynn Frazier, MSW, LCSW
• Viviloria Frazier, B.S.
• Whitney Saige Frazier, PT, DPT
• Caitlin Marie Fred
• Kevin G Fredenburg, PT
• Marina Frederick, PHARMD, RPH
• Frederico Tepedino DMD PA
• Kirsten E Frederiksen, MD

• Clinical Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.