Carole Anne Petiet, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY8311 Issued in CA

Practice address

2340 Ward St
Suite 105
Berkeley, CA 94705

Phone

(510) 843-6760

Fax

(303) 379-3611

NPI assigned

Dec 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215005541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 WARD ST",
            "address_2": "SUITE 105",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94705",
            "telephone_number": "510-843-6760",
            "fax_number": "303-379-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 WARD ST",
            "address_2": "SUITE 105",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94705",
            "telephone_number": "510-843-6760",
            "fax_number": "303-379-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIET",
        "first_name": "CAROLE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00PL83110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PSYCHOLOGY",
            "identifier": "PSY8311",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cal Petersen
• Trudi J Petersen, N.P.
• Katherine Trawick Peterson, DDS
• Kristin Peterson, BCBA
• Tracy Peterson, LCSW
• Lisa Petras, LMFT
• Stephanie Petreas, RN, FNP
• Zara Petrosyan
• Pets Partnership (PETS Referral Center)
• Lauren Bacall Pettis

• Clinical Psychologist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.