Provider Demographics
NPI:1366138059
Name:CARPENTER, ZOEY LOUISE
Entity type:Individual
Prefix:
First Name:ZOEY
Middle Name:LOUISE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 SANTA FE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-1656
Mailing Address - Country:US
Mailing Address - Phone:510-552-8472
Mailing Address - Fax:
Practice Address - Street 1:1970 SANTA FE ST
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-1656
Practice Address - Country:US
Practice Address - Phone:510-552-8472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician