Richard Carolan, EDD./ PSYCHOLOGIST

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 14289 Issued in CA

Practice address

7 4TH Street
Suite 29
Petaluma, CA 94952

Phone

(707) 971-0212

NPI assigned

Nov 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sonoma Therapeutic Arts and Education, a Psychological Corporation

  • Psychologist
  • Petaluma, CA
  • NPI 1942924899
  NPD Authorized official

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1760637607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 4TH STREET",
            "address_2": "SUITE 29",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952",
            "telephone_number": "707-971-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 4TH STREET",
            "address_2": "SUITE 29",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952",
            "telephone_number": "707-971-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROLAN",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "EDD./ PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 14289",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY 14289",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY 14289",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Carbone, OTR/L
• Samantha Leigh Cardozo, M.S.
• Lisa Ryan Carlson, RN
• Savannah Carlson
• Laurel Whitney Carmichael, PHARMD
• Carpe Diem, Massage and Skin
• Debbie A Carpenter, CERTIFIED MASSAGE TH
• Amanda Faye Dragos Carr, IBCLC
• Ynhi Thanh Carr, PHARMD
• Alejandro Daniel Carranza

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.