Nicole Arlene Peterson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

682 Briergate Way
Hayward, CA 94544-7245

Phone

(510) 487-2910

Fax

(510) 487-2016

NPI assigned

Jun 19, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Magnolia Women'S Recovery Programs, Inc.

  • Substance Abuse Rehabilitation Facility
  • Hayward, CA
  • NPI 1528258670
  NPD (past)

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1114411568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 BRIERGATE WAY",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945447245",
            "telephone_number": "510-487-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 BRIERGATE WAY",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945447245",
            "telephone_number": "510-487-2910",
            "fax_number": "510-487-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "NICOLE",
        "middle_name": "ARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "010081AN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rashel Perry, LCSW
• Aaron Pessl, M.D.
• Amy Pete, MSW
• Brett Michael Peters
• Elise Marie Peters, RD
• Brooklyn Petty
• Taylor Petty
• Anh N. Pham, D.D.S., M.S.
• Binh Pham
• David Ronald Pham

• Case Manager/Care Coordinator in Hayward, CA
• Providers in Hayward, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.