Individual
DR. CAROLE ANNE PETIET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2340 WARD ST, SUITE 105, BERKELEY, CA 94705
(510) 843-6760
(303) 379-3611
Mailing address
2340 WARD ST, SUITE 105, BERKELEY, CA 94705
(510) 843-6760
(303) 379-3611
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY8311
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PL83110
BLUE CROSS BLUE SHIELD
CA
01
—
PSY8311
BOARD OF PSYCHOLOGY
CA
Enumeration date
12/04/2006
Last updated
07/08/2007
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