Individual
ALIDA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
5785 SAINT HELENA RD, SANTA ROSA, CA 95404-9690
(707) 494-1959
Mailing address
5785 SAINT HELENA RD, SANTA ROSA, CA 95404-9690
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1091198
IL
Other
Enumeration date
02/04/2014
Last updated
02/04/2014
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