Individual
DR. DOUGLAS ALLEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
16935 W BERNARDO DR, 238, SAN DIEGO, CA 92127-1634
(619) 223-8511
Mailing address
2632 WORDEN ST., 189, SAN DIEGO, CA 92110-5841
(619) 223-8511
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY 20082
CA
103TC0700X
Clinical Psychologist
Primary
PSY 20082
CA
103TH0004X
Health Psychologist
PSY 20082
CA
Other
Enumeration date
07/26/2007
Last updated
10/18/2007
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