JORDAN MICHELE PETERSEN


Address: 1300 N Dutton Ave, Santa Rosa, CA 95401-7112
Phone: 7073033395

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 124Q00000X Dental Hygienist RDH32940 CA Dental Providers

Other Providers JORDAN PETERSEN

NPI Name Taxonomy Address Enumeration
1841818861 Jordan Petersen Behavior Technician 12222 S 1000 E Ste 3, Draper, UT 84020-3203 2020-07-07

Office Location

Street Address 1300 N DUTTON AVE
City SANTA ROSA
State CA
Zip Code 95401-7112

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 124Q00000X
Grouping Dental Providers
Classification Dental Hygienist

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City SANTA ROSA
Zip Code 95401

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Dataset Information

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.

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