Provider Demographics
NPI:1952062507
Name:PEART, KAMELA MONIQUE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KAMELA
Middle Name:MONIQUE
Last Name:PEART
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KAMELA
Other - Middle Name:MONIQUE
Other - Last Name:BASRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1902 BELTAINE CT
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-3860
Mailing Address - Country:US
Mailing Address - Phone:415-823-9728
Mailing Address - Fax:
Practice Address - Street 1:2340 WARD ST STE 204
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1147
Practice Address - Country:US
Practice Address - Phone:415-823-9728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129698106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist