Individual
JAMIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
286 S 16TH ST, GROVER BEACH, CA 93433-2245
(805) 473-7050
(805) 474-7473
Mailing address
286 S 16TH ST, GROVER BEACH, CA 93433-2245
(805) 473-7050
(805) 474-7473
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
820652
CA
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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