Individual
CAROLYN JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 23RD ST, RICHMOND, CA 94804-1338
(510) 229-5000
(510) 235-3112
Mailing address
230 S 17TH ST, RICHMOND, CA 94804-2604
(510) 233-5828
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/21/2008
Last updated
02/05/2008
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