Individual
DESHAY TYWIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10918 VILLA HERMOSA DR, BAKERSFIELD, CA 93311-9373
(661) 654-8559
Mailing address
7849 OCEANUS DR, LOS ANGELES, CA 90046-2042
(310) 909-3817
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
CA
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
08/09/2022
Last updated
04/28/2025
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