CANDICE DIANE PETERSON (NPI# 1992956379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992956379 |
| Entity Type | Individual |
| Full Name | CANDICE DIANE PETERSON |
| Practice Address |
902 Tuolumne St Vallejo CA 94590-4641 |
| Mailing Address |
1972 Maybelle Dr Pleasant Hill CA 94523-2708 |
| Practice Telephone | 7076488121 |
| Mailing Telephone | 9257987191 |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2008-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902362189 | Candice Peterson | Counselor | 2118 Blaisdell Ave, Minneapolis, MN 55404-2415 | 2019-02-13 |
| 1376976530 | Candice J Peterson | Nurse Practitioner | 146 E Geneva Sq, Lake Geneva, WI 53147-9694 | 2013-08-12 |
| Street Address |
902 TUOLUMNE ST |
| City | VALLEJO |
| State | CA |
| Zip Code | 94590-4641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447337746 | Robert Brandon Weis | Counselor | 902 Tuolumne St, Vallejo, CA 94590-4641 | 2006-11-01 |
| 1669900098 | Monica Germaine Shepard | Counselor | 902 Tuolumne St, Vallejo, CA 94590-4641 | 2017-05-30 |
| 1619002201 | Claudia Lorena Sanchez | Counselor | 902 Tuolumne St, Vallejo, CA 94590-4641 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265051445 | Jaspreet Bains | Licensed Vocational Nurse | 508 Alabama Street, Vallejo, CA 94590 | 2020-04-08 |
| 1467097527 | Deneane Hannon | Behavioral Analyst | 238 Georgia St. Ste 102, Vallejo, CA 94590 | 2019-11-13 |
| 1780243196 | Abla Harara Almoraissi | Health Educator | John F. Kennedy Library, 505 Santa Clara St, Vallejo, CA 94590 | 2019-06-10 |
| 1891264461 | Brian Emory Kellogg | Marriage & Family Therapist | 525 Oregon St., Php/iop, Vallejo, CA 94590 | 2018-11-13 |
| 1952801862 | Carica Theresa Saraza Macariola | Specialist/Technologist | 1007 Solano Avenue, Vallejo, CA 94590 | 2018-02-16 |
| 1770007973 | Deborah A Johnson-white | Licensed Vocational Nurse | 908 Tuolumne, Vallejo, CA 94590 | 2017-07-29 |
| 1306378260 | Edgar Diaz | Counselor | 236 Georgia Street Suite 101, Vallejo, CA 94590 | 2017-03-30 |
| 1528440096 | Soren Perry | Counselor | 236 Georgia St., Vallejo, CA 94590 | 2015-06-22 |
| 1518366327 | Kimberly A Holland | Counselor | 631 Tennessee Street Suite 201, Vallejo, CA 94590 | 2014-08-18 |
| 1841605193 | Lawana Lofton | Psychologist | 88 Valle Vista Drive, Unit 6310, Vallejo, CA 94590 | 2014-06-25 |
| Find all providers in zip 94590 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669072302 | Imani Rivers | Counselor | 135 Gateway Ct, Vallejo, CA 94589-4339 | 2020-10-30 |
| 1942860267 | Enkindled Minds Counseling and Wellness | Counselor | 2507 Springs Rd, Vallejo, CA 94591-5612 | 2019-06-18 |
| 1689164311 | Karen Vanessa Alvarado | Counselor | 160 Glen Cove Marina Rd E, Vallejo, CA 94591-7290 | 2018-05-17 |
| 1154776052 | Robben Stallworth | Counselor | 312 Starboard Dr, Vallejo, CA 94590-4024 | 2016-04-28 |
| 1093176273 | Vincent Charles | Counselor | 236 Georgia St Ste 101, Vallejo, CA 94590-5962 | 2016-03-15 |
| 1528440096 | Soren Perry | Counselor | 236 Georgia St., Vallejo, CA 94590 | 2015-06-22 |
| 1497132427 | Sierra Voss | Counselor | 144 Harrier Ave, Vallejo, CA 94590-3710 | 2015-04-28 |
| 1376935452 | Diana Harvey | Counselor | 1827 Alabama St, Vallejo, CA 94590-4739 | 2015-02-25 |
| 1518366327 | Kimberly A Holland | Counselor | 631 Tennessee Street Suite 201, Vallejo, CA 94590 | 2014-08-18 |
| 1174959811 | Chris William Cook | Counselor | 1243 Florida St, Vallejo, CA 94590-5540 | 2013-09-25 |
| Find all providers in VALLEJO | ||||
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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.