DR. JACQUELINE BERNADINE PETRAVAGE


Address: Veteran's Hospital, 500 Foothill Blvd, Bldg 47, Salt Lake City, UT 84148-0001
Phone: 8015821565

DR. JACQUELINE BERNADINE PETRAVAGE (NPI# 1104861079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104861079
Entity Type Individual
Full Name DR. JACQUELINE BERNADINE PETRAVAGE
Credential M.D.
Practice Address Veteran's Hospital, 500 Foothill Blvd
Bldg 47
Salt Lake City
UT 84148-0001
Mailing Address 500 Foothill Blvd
Salt Lake City
UT 84148-0001
Practice Telephone 8015821565
Practice Fax Number 8015842544
Mailing Telephone 8015821565
Mailing Fax Number 8015842544
Enumeration Date 2006-06-17
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0800X Psychiatry & Neurology
Specialization: Psychiatry
1664161205 UT Allopathic & Osteopathic Physicians

Office Location

Street Address VETERAN'S HOSPITAL, 500 FOOTHILL BLVD
BLDG 47
City SALT LAKE CITY
State UT
Zip Code 84148-0001

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598211799 Jacquelyn Rae Contant Dietitian, Registered 500 Foothill Dr. (120), Salt Lake City, UT 84148 2016-08-28
1699127811 Taylor Alford Pharmacist 500 Foothills Drive, Salt Lake City, UT 84148 2016-07-12
1356792162 Sarah Hummel Genetic Counselor, MS 500 Foothill Drive, Sarah Hummel, Va Salt Lake City, Genomic Medicine (10p4e), Salt Lake City - Salt Lake, UT 84148 2016-06-23
1174936140 Elizabeth Shade Cardenas Nurse Practitioner 500 Foothill Drive #182h, Veterans Healthcare Administration, Salt Lake City, UT 84148 2014-06-08
1386904043 David Earl Moore Specialist 500 Foothill Blvd (research), George E. Wahlen Va Healthcare System, Salt Lake City, UT 84148 2012-05-29
1790059038 Deborah Ernstein Holley Hartzfeld Genetic Counselor, MS 615 Arapeen Drive #212, Salt Lake City, UT 84148 2012-03-05
1073823720 Diana Lynn Robbins Social Worker 9140 W. Post Road, Las Vegas, NV 84148 2010-10-15
1659534394 Katherine Margaret Dunn Genetic Counselor, MS 500 Foothill Drive (151z), Salt Lake City, UT 84148 2008-07-02
1730381625 Douglas James Ball Medical Genetics Va Salt Lake City Health Care System 10p11, Salt Lake City, UT 84148 2007-06-03
1245339530 Daniel H Priestly Radiology 500 Foothill Dr., Salt Lake City, UT 84148 2006-09-22
Find all providers in zip 84148

Taxonomy Information

Taxonomy Code 2084P0800X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Psychiatry

Taxonomy Definition

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 laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811549637 Nume Tms Utah, Pllc Psychiatry & Neurology 560 S 300 E Ste 115, Salt Lake City, UT 84111-3562 2019-07-11
1497288351 Tyler Durns Psychiatry & Neurology 50 N Medical Dr Salt Lake City, Salt Lake City, UT 84132-0001 2017-04-07
1457705279 Heather Wark Psychiatry & Neurology 3313 E Coronet Dr, Salt Lake City, UT 84124-3102 2016-04-18
1114311255 Shane Verhoef Psychiatry & Neurology 500 Foothill Dr Bldg 16, Salt Lake City, UT 84148-1023 2015-03-26
1376947051 University of Utah Behavioral Health Services Psychiatry & Neurology 30 N 1900 E Ste 1b620, Salt Lake City, UT 84132-0002 2014-10-09
1700120334 R. Duncan Wallace, M.d., P.C. Psychiatry & Neurology 2972 S Devonshire Cir, Salt Lake City, UT 84108-2526 2012-11-20
1336407790 Anthony Michael Petersen Psychiatry & Neurology University of Utah Psychiatry Department, 50 North Medical Drive, Salt Lake City, UT 84132-0001 2012-04-24
1982971826 Robert Allan Weitzel Psychiatry & Neurology 78 U St, Salt Lake City, UT 84103-4304 2011-11-21
1427349042 Kristen Leigh Pagel Psychiatry & Neurology 30 N 1900 E Rm 1c412, Gme Office, Salt Lake City, UT 84132-0002 2011-04-30
1952690919 Brent Michael Kious Psychiatry & Neurology University Hospital 50 N Medical Dr, Salt Lake City, UT 84132-0001 2011-03-30
Find all providers in SALT LAKE CITY

Competitor

Search similar providers

City SALT LAKE CITY
Zip Code 84148

Improve Information

Please comment or provide details below to improve the information on DR. JACQUELINE BERNADINE PETRAVAGE.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches