Provider Demographics
NPI:1669187928
Name:JANOPAUL, PETRA E (AMFT, APCC)
Entity type:Individual
Prefix:
First Name:PETRA
Middle Name:E
Last Name:JANOPAUL
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 170004
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-0004
Mailing Address - Country:US
Mailing Address - Phone:415-570-9953
Mailing Address - Fax:
Practice Address - Street 1:2014 10TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1303
Practice Address - Country:US
Practice Address - Phone:707-243-3914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12997101YP2500X
CA136462106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA136462OtherBOARD OF BEHAVIORAL SCIENCES
CA12997OtherBOARD OF BEHAVIORAL SCIENCES