MR. SALVATORE PETERSEN (NPI# 1972031987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972031987 |
| Entity Type | Individual |
| Full Name | MR. SALVATORE PETERSEN |
| Credential | RN |
| Practice Address |
103 Bodin Cir Fairfield CA 94535-1801 |
| Practice Telephone | (707) 437-1802 |
| Mailing Telephone | 7074371802 |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2017-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
545718 | CA | Nursing Service Providers |
| Street Address |
103 BODIN CIR |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94535-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003899279 | Myo Swe Chang | Internal Medicine | 103 Bodin Cir, Bld 778, Fairfield, CA 94535-1801 | 2005-11-22 |
| 1417342544 | Sarah Schobert | Registered Nurse | 103 Bodin Cir, Fairfield, CA 94535-1801 | 2015-04-06 |
| 1396997169 | Carlton E. Spradley | Counselor | 103 Bodin Cir, Fairfield, CA 94535-1801 | 2008-10-10 |
| 1972702710 | Christen Dardenne | Physician Assistant | 103 Bodin Cir, Fairfield, CA 94535-1801 | 2007-07-12 |
| 1427184738 | Leslee Rae Kassing | Psychologist | 103 Bodin Cir, Travis Afb Va, Fairfield, CA 94535-1801 | 2007-02-23 |
| 1699784165 | Savita Saraswathi Nallapa | Internal Medicine | 103 Bodin Cir, Va Outpatient Clinic, Fairfield, CA 94535-1801 | 2006-08-05 |
| 1679513089 | Martinez Vamc | Clinic/Center | 103 Bodin Cir, Travis Afb, Fairfield, CA 94535-1801 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093146243 | Andrea Courtney Ruybal | Registered Nurse | 2101 Courage Dr, Fairfield, CA 94533-6717 | 2013-12-12 |
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| Find all providers with the same taxonomy | ||||
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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.