Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY15572 | CA |
NPI | 1588726665 |
---|---|
Provider Name | Dr. Karen Anne Peters |
First Address | San Martin, CA 95046-9202 |
Second Address | Cupertino, CA 95014-0712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 03/01/2022 |