Individual provider Active NPI

Joanna Peterson, RN IBCLC

  • Lactation Consultant (Registered Nurse)
  • Valencia, CA
National Provider Identifier
1013627744
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
R0092541 Issued in OK
Practice address
23020 Ash Glen Cir
Valencia, CA 91354-2001
Phone
(661) 495-7768
NPI assigned
Dec 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X R0092541 OK Primary

Addresses

Primary practice location

23020 Ash Glen Cir
Valencia, CA 91354-2001

Mailing address

4200 W Laredo St
Broken Arrow, OK 74012-7576
Phone (661) 495-7768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R0092541OKMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Joanna Peterson Lactation Consulting Lactation Consultant CurrentSince Jun 29, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1013627744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W LAREDO ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740127576",
            "telephone_number": "661-495-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23020 ASH GLEN CIR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913542001",
            "telephone_number": "661-495-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOANNA",
        "credential": "RN IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OK",
            "license": "R0092541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.