Pedersen, Walter
Pedersen, Walter is an individual health care provider with primary practice located at 2494 Lake Tahoe Blvd Ste B2 , South Lake Tahoe CA 96150-7142. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Pedersen, Walter can be contacted via phone (530) 541-4594.Contact Information
Primary practice address
2494 Lake Tahoe Blvd Ste B2
South Lake Tahoe CA 96150-7142
Phone: (530) 541-4594
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1730301128 |
|---|---|
| LBN Legal business name | Pedersen, Walter |
| Credentials | CADC II |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2007 |
| Last updated | Apr 10th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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