Individual
BRIAN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
1400 N JOHNSON AVE STE 101, EL CAJON, CA 92020-1651
(619) 442-0277
Mailing address
1400 N JOHNSON AVE STE 101, EL CAJON, CA 92020-1651
(619) 442-0277
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
748137
CA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
748137
CA
Other
Enumeration date
03/17/2015
Last updated
04/09/2023
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