Individual
MR. ETIENNE ANDRE' PIETERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 COURT ST STE 210, JACKSON, CA 95642-2163
(209) 257-1980
(209) 257-1989
Mailing address
601 COURT ST STE 210, JACKSON, CA 95642-2163
(209) 257-1980
(209) 257-1989
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/17/2025
Last updated
03/02/2026
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