Individual
DR. CARRIE PROFITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, HSPP
Contact information
Practice address
10333 EL CAMINO REAL, ATASCADERO, CA 93422-5808
(805) 468-2000
(805) 468-6011
Mailing address
1600 9TH STREET, ROOM 150, FISCAL ALLOCATIONS AND ESTIMATES UNIT, SACRAMENTO, IN 95814-6414
(916) 651-9475
(916) 651-8908
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041923
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200506080
—
IN
Enumeration date
07/02/2006
Last updated
07/10/2013
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