Individual provider · Type 1 NPI
Jacqueline Bernadine Petravage, MD
Psychiatry Physician · Salt Lake City, UT
Practice location
Veteran's Hospital, 500 Foothill Blvd, Bldg 47
Salt Lake City, UT 84148-0001
Fax (801) 584-2544
Mailing address
500 Foothill Blvd
Salt Lake City, UT 84148-0001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry Physician Primary | 2084P0800X | 1664161205 (UT) |
Psychiatry Physician: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic la…
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About NPI 1104861079
Jacqueline Bernadine Petravage, MD's National Provider Identifier is 1104861079, issued on Jun 17, 2006. The primary taxonomy on file is Psychiatry Physician (2084P0800X), and the practice location is in Salt Lake City, UT. The record was last updated on Jul 13, 2026.