Jeraleen M. Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 28561 Issued in CA

Practice address

10601 Civic Center Dr Ste 100L
Rancho Cucamonga, CA 91730-3878

Phone

(909) 291-9349

NPI assigned

Apr 11, 2007

Last updated

Dec 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Wisdom Tree Counseling

  • Clinical Social Worker
  • Rancho Cucamonga, CA
  • NPI 1346790524
  NPD (past) Authorized official

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1063635563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4571",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917294571",
            "telephone_number": "909-291-9349",
            "fax_number": "888-272-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 CIVIC CENTER DR STE 100L",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303878",
            "telephone_number": "909-291-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JERALEEN",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 28561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Peters, BCBA
• Melinda J. Peters, PTA
• Michael Peters, BCBA
• Bjoern Paolo Petersen
• Natalia Petersen
• Miles Ellis Peterson, PHD
• Vanessa Noel Browne Peterson, DDS, MS
• Petrichor Physical Therapy a Professional Corporation
• Arezou Petrie, RPH
• Louis Petrie, PHARM.D

• Clinical Social Worker in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.