Provider Demographics
NPI:1952630543
Name:CARPENTER, PLEAS EDWARD (MFT)
Entity Type:Individual
Prefix:MR
First Name:PLEAS
Middle Name:EDWARD
Last Name:CARPENTER
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 1:1600 ROWYN CIR
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-4351
Mailing Address - Country:US
Mailing Address - Phone:530-872-8730
Mailing Address - Fax:
Practice Address - Street 1:500 COHASSET RD
Practice Address - Street 2:SUITE 15
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2260
Practice Address - Country:US
Practice Address - Phone:530-891-2945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11650106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist