Individual
ANTJE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
450 FOURTH AVENUE, STE 215, CHULA VISTA, CA 91910-4428
(619) 498-5454
(619) 528-4625
Mailing address
PO BOX 609001, SAN DIEGO, CA 92160-9001
(619) 528-4600
(619) 528-4625
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MFC42087
CA
Other
Enumeration date
05/25/2006
Last updated
07/08/2007
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