Individual
TIMOTHY D. PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2235 MERCURY WAY, SANTA ROSA, CA 95407-5473
(707) 239-4426
Mailing address
2235 MERCURY WAY, SANTA ROSA, CA 95407-5473
(707) 239-4426
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
39646
KY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
C195627
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64105463
—
KY
Enumeration date
06/09/2006
Last updated
06/24/2024
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