Individual
JANE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Contact information
Practice address
5020 BALTIMORE DR STE A, LA MESA, CA 91942-0692
(619) 460-0180
Mailing address
5020 BALTIMORE DR STE A, LA MESA, CA 91942-0692
(619) 460-0180
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1081
CA
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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