Individual
KIMBERLY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
95013898
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
95013898
CA
Other
Enumeration date
10/25/2021
Last updated
08/15/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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