Provider Demographics
NPI:1326558677
Name:CARPINITO, THERESA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:M
Last Name:CARPINITO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TAMAL PLZ STE 235
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1128
Mailing Address - Country:US
Mailing Address - Phone:415-417-1847
Mailing Address - Fax:
Practice Address - Street 1:200 TAMAL PLZ STE 235
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1128
Practice Address - Country:US
Practice Address - Phone:415-417-1847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-01
Last Update Date:2017-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical