Individual
DR. PHILIP RANDOLPH YATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
4465 BAYMEADOWS RD STE 8, JACKSONVILLE, FL 32217-4727
(904) 731-7222
(904) 731-7406
Mailing address
4465 BAYMEADOWS RD STE 8, JACKSONVILLE, FL 32217-4727
(904) 731-7222
(904) 731-7406
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY0002702
FL
103TC1900X
Counseling Psychologist
PY0002702
FL
103TF0000X
Family Psychologist
Primary
PY0002702
FL
Other
Enumeration date
01/27/2007
Last updated
09/11/2025
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