Individual provider · Type 1 NPI

Timothy William Pettett, SUDRC #16547

Counselor · San Jose, CA

NPI number 1104545490 Active

Practice location

298 Bernal Rd
San Jose, CA 95119-1809

Call (510) 337-7950 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1104545490

Timothy William Pettett, SUDRC #16547's National Provider Identifier is 1104545490, issued on Aug 22, 2022. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in San Jose, CA. The record was last updated on Oct 20, 2024.