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Individual

LESLIE PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
268 VILLAGE COMMONS BLVD UNIT 19, CAMARILLO, CA 93012-6828
(423) 313-8812
Mailing address
268 VILLAGE COMMONS BLVD UNIT 19, CAMARILLO, CA 93012-6828
(423) 313-8812

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP21870
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
21870
CA

Other

Enumeration date
04/16/2014
Last updated
08/09/2023
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