Peterson, Keith R

Peterson, Keith R is an sole proprietor health care provider with primary practice located at 6 Venture Suite 350, Irvine CA 92618-3340. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Peterson, Keith R can be contacted via phone (949) 683-8789.

Contact Information

Primary practice address
6 Venture Suite 350 Irvine CA 92618-3340
Fax: (949) 581-4484
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 15859 California

Profile Details

NPI number 1023144573
LBN Legal business name Peterson, Keith R
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2007
Last updated Jul 8th, 2007 - about 17 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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