Provider Demographics
NPI:1427436344
Name:BARRETO, PATRICIA (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:BARRETO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 JEKYLL CT
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-4403
Mailing Address - Country:US
Mailing Address - Phone:205-370-1832
Mailing Address - Fax:904-467-3143
Practice Address - Street 1:1896 S 14TH ST STE 6
Practice Address - Street 2:
Practice Address - City:FERNANDINA BCH
Practice Address - State:FL
Practice Address - Zip Code:32034-4416
Practice Address - Country:US
Practice Address - Phone:190-431-0965
Practice Address - Fax:904-467-3143
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10425103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical