Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jacqueline Bernadine Petravage, MD

Individual provider Psychiatry Physician · NPI 1104861079

Dr. Jacqueline Bernadine Petravage, MD is a Psychiatry Physician in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2006.

Licensed in
UT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

Veteran's Hospital 500 Foothill Blvd Bldg 47
Salt Lake City, UT 84148-0001
Phone: (801) 582-1565
Fax: (801) 584-2544
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 1664161205 (UT)

Record details

NPI number1104861079
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 17, 2006
Last updated in NPPESJuly 13, 2026

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