JORDAN MICHELE PETERSEN (NPI# 1386295160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386295160 |
Entity Type | Individual |
Full Name | JORDAN MICHELE PETERSEN |
Credential | RDH |
Practice Address |
1300 N Dutton Ave Santa Rosa CA 95401-7112 |
Mailing Address |
911 Kensington Pl Petaluma CA 94954-7459 |
Practice Telephone | 7073033395 |
Mailing Telephone | 4152468524 |
Enumeration Date | 2019-09-24 |
Last Update Date | 2019-09-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | RDH32940 | CA | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841818861 | Jordan Petersen | Behavior Technician | 12222 S 1000 E Ste 3, Draper, UT 84020-3203 | 2020-07-07 |
Street Address |
1300 N DUTTON AVE |
City | SANTA ROSA |
State | CA |
Zip Code | 95401-7112 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487649711 | Patricia Whooley Kulawiak | Family Medicine | 1300 N Dutton Ave, Santa Rosa, CA 95401 | 2005-09-13 |
1245830223 | Alexy Francisco Andrade | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2020-10-28 |
1558997569 | Nicole Fernandes | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2020-03-21 |
1588207351 | Megan Culligan | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-10-23 |
1376185272 | Ryan Duval | Acupuncturist | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-10-11 |
1871153734 | Priscilla Lujan Rodriguez | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-06-13 |
1770148108 | Jennifer Nicole Francis | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2019-05-01 |
1770059750 | Brittany English | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2018-10-17 |
1386129294 | Claire Maureen Kugler | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2018-09-26 |
1689159535 | Jessica Leavitt | Nurse Practitioner | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2018-09-26 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
Find all providers in zip 95401 |
Taxonomy Code | 124Q00000X |
Grouping | Dental Providers |
Classification | Dental Hygienist |
An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
1548679400 | Jill Bauer | Dental Hygienist | 2740 Ironstone Circle, Santa Rosa, CA 95407 | 2014-08-05 |
1669896981 | Renee Marie Marchant | Dental Hygienist | 245 Doyle Park Dr, Santa Rosa, CA 95405-4511 | 2014-02-06 |
1205278587 | Susan Elizabeth Slade | Dental Hygienist | 711 Stony Point Rd, Santa Rosa, CA 95407-6802 | 2013-07-26 |
1205120078 | Deborah Ann Chigazola | Dental Hygienist | 5815 Owl Hill Ave, Santa Rosa, CA 95409-4341 | 2011-06-08 |
1417135286 | Ingri Seath Sparling | Dental Hygienist | 4638 Montgomery Dr, Santa Rosa, CA 95409-5311 | 2008-02-04 |
1316153794 | Jennifer Apocotos-kirk | Dental Hygienist | 418 Aviation Blvd, Sutie A, Santa Rosa, CA 95403-1074 | 2007-05-15 |
1154339059 | Katherine Carmel Kane | Dental Hygienist | 527 Squirrel Ct, Santa Rosa, CA 95401-5762 | 2006-08-04 |
1538646807 | Samantha Makinano | Dental Hygienist | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2018-07-19 |
1548476732 | Mara Marie Hoban | Dental Hygienist | 418 Aviation Blvd Ste A, Santa Rosa, CA 95403-1074 | 2007-05-15 |
Find all providers in SANTA ROSA |
City | SANTA ROSA |
Zip Code | 95401 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.