Individual
DR. AUSTIN ABBOTT CARPENTER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
645 W HARDING WAY, SUTIE 2, STOCKTON, CA 95204-5688
(209) 465-4955
(559) 386-1085
Mailing address
PO BOX 249, AVENAL, CA 93204-0249
(443) 554-6360
(559) 386-1085
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 16361
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY 163610
—
CA
Enumeration date
03/17/2007
Last updated
07/09/2007
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