Individual
DR. DAENA LAUREEN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH, MA
Contact information
Practice address
299 12TH ST STE A, MARINA, CA 93933-6003
(831) 647-7652
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35387
SC
2084P0800X
Psychiatry Physician
Primary
A167968
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
VT
Other
Enumeration date
04/09/2010
Last updated
07/07/2021
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