Peterson, Tyler

Peterson, Tyler is an individual health care provider with primary practice located at 4001 Hwy 104 , Ione CA 95640. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Peterson, Tyler can be contacted via phone (209) 274-4911.

Contact Information

Primary practice address
4001 Hwy 104 Ione CA 95640
Phone: (209) 274-4911
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY33794 California

Profile Details

NPI number 1558017822
LBN Legal business name Peterson, Tyler
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2022
Last updated Apr 26th, 2023 - about 2 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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