Healthcare Provider Details

I. General information

NPI: 1265561237
Provider Name (Legal Business Name): SYLVIA PETITT MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4633 OLD IRONSIDES DR
SANTA CLARA CA
95054-1807
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-6100
  • Fax: 661-868-6133
Mailing address:
  • Phone: 661-868-6601
  • Fax: 661-868-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number41532
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: