Provider Demographics
NPI:1376600403
Name:CARPENTIERI, ANTHONY PETER (MFT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:PETER
Last Name:CARPENTIERI
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 59TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1503
Mailing Address - Country:US
Mailing Address - Phone:510-658-6485
Mailing Address - Fax:
Practice Address - Street 1:2315 PRINCE ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1915
Practice Address - Country:US
Practice Address - Phone:510-849-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC17743101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health