Individual
AMY JEAN PETERSEN-FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
653 CANYON RD, NOVATO, CA 94947-4331
(415) 892-1628
Mailing address
4300 BLANK RD, SEBASTOPOL, CA 95472-6315
(707) 479-7810
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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