Individual
DR. TARA JEAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
10085 CARROLL CANYON RD, SAN DIEGO, CA 92131-1138
(858) 208-3463
Mailing address
10 VERONA LN, FOOTHILL RANCH, CA 92610-1913
(949) 616-4809
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
35302
CA
Other
Enumeration date
01/18/2021
Last updated
09/10/2024
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