Individual
DOMINIQUE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3200 KEARNEY ST, FREMONT, CA 94538-2299
(510) 490-1222
Mailing address
430 ALPINE HEIGHTS RD, ALPINE, CA 91901-2872
(661) 330-7032
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61911
CA
Other
Enumeration date
12/07/2022
Last updated
10/10/2025
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