Individual
CANDICE DIANE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
902 TUOLUMNE ST, VALLEJO, CA 94590-4641
(707) 648-8121
Mailing address
1972 MAYBELLE DR, PLEASANT HILL, CA 94523-2708
(925) 798-7191
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/03/2008
Last updated
10/09/2008
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