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Thea A. Privette

Marriage & Family Therapist

Behavioral Health & Social Service Providers

3436 Mendocino Ave Ste A, Santa Rosa, CA 95403-2180

PECOS Enrollment

Based on the most recent information from CMS, provider Thea A. Privette does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1932629656
Provider Type
Individual
Full Name
Privette, Thea A.
Credential
MA, MFTI

Gender
Female
Sole Proprietor
No
Enumeration Date
6/23/2017
Last Updated
6/8/2021

Contact Information

Practice Location

3436 Mendocino Ave Ste A, Santa Rosa, CA 95403-2180

(707) 495-0367

Unlisted Fax

Mailing Location

2777 Yulupa Ave Ste 298, Santa Rosa, CA 95405-8584

(707) 495-0367

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 100934 California
Code 101Y00000X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 100934 California

Thea A. Privette

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Sahr, Valerie Ann

Carlozzi, Dante

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Ekren, Kathy Mae