Provider Demographics
NPI:1447446083
Name:JORDAN, RONDA RANEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:RONDA
Middle Name:RANEE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 NW 27TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-7102
Mailing Address - Country:US
Mailing Address - Phone:239-287-1044
Mailing Address - Fax:352-268-1090
Practice Address - Street 1:6425 NW 27TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-7102
Practice Address - Country:US
Practice Address - Phone:239-287-1044
Practice Address - Fax:352-268-1090
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7560103T00000X
FL7560103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist