KATRINA LAREA PETTERSEN LEP 4489
NPI 1104632991
Psychologist - School in San Jose, CA

Active since December 05, 2024
1261 LINCOLN AVE STE 104, SAN JOSE, CA 95125(408) 439-1111 Get Directions Write a Review

NPPES record last updated: December 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 19, 2024, Dec 5, 2024 (2 updates tracked since 2024).

About Katrina Larea Pettersen Lep 4489 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATRINA LAREA PETTERSEN LEP 4489 (NPI 1104632991) is an individual school provider in San Jose, California, licensed in California (4489) and active in the NPI registry since December 2024.

NPPES Registry Identity

NPI1104632991
Entity TypeIndividualFemale
Primary Taxonomy103TS0200X
Provider Legal NameKATRINA LAREA PETTERSENCredential: LEP 4489
Location Address1261 LINCOLN AVE STE 104San Jose, CA 95125-3030
Mailing Address2893 Union AveSan Jose, CA 95124-1435 · (760) 902-8990
Sole ProprietorNo
Enumeration DateDecember 5, 2024
Last NPPES UpdateDecember 19, 20242 updates tracked since enumeration
NPPES CertifiedDecember 19, 2024
NPI 1104632991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · SchoolBehavioral Health & Social Service Providers
Taxonomy Code103TS0200X
License Licensed in CA · 4489
Definition
A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development
1261 LINCOLN AVE STE 104, San Jose, CA 95125

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (School)
1261 LINCOLN AVE STE 104
SAN JOSE, CA 95125
Psychologist (School)
1261 LINCOLN AVE STE 104
SAN JOSE, CA 95125
Psychologist (School)
1261 LINCOLN AVE STE 104
SAN JOSE, CA 95125

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katrina Pettersen's NPI number?

The NPI number for Katrina Pettersen is 1104632991. It was assigned to this individual provider in the NPPES registry on December 5, 2024.

Where is Katrina Pettersen located?

Katrina Pettersen practices at 1261 Lincoln Ave Ste 104, San Jose, CA 95125. The listed phone number is (408) 439-1111.

What is Katrina Pettersen's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in School, with taxonomy code 103TS0200X.

When was this NPI record last updated?

The NPPES record for Katrina Pettersen was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.