Individual
ANTONIO PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
815 POLLARD RD, LOS GATOS, CA 95032-1438
(863) 465-7200
Mailing address
830 AGUA MINERAL PL, EL PASO, TX 79928-9056
(817) 727-7069
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
16151
FL
235Z00000X
Speech-Language Pathologist
Primary
28161
CA
Other
Enumeration date
06/11/2018
Last updated
04/30/2023
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