Thomas C Petersen, PH.D. MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT 14862 Issued in CA

Practice address

157 N Glendora Ave Ste 215
Glendora, CA 91741-3369

Phone

(626) 278-0677

Fax

(626) 812-5674

NPI assigned

Sep 21, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154420651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W FOOTHILL BLVD # 452",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917415301",
            "telephone_number": "626-278-0677",
            "fax_number": "626-812-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 N GLENDORA AVE STE 215",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413369",
            "telephone_number": "626-278-0677",
            "fax_number": "626-812-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "THOMAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.  MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 14862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Haydee Perez-Melendez, MS
• Carolina Perez, LCSW
• Damaris Perez
• Leticia Jimenez Perez
• Maria Cristina Petersen, RN
• Letrice Pettway
• Derrick Thanh Pham, PHARM. D
• Kimberly Pham, PA-C
• Melissa Philipson
• Phillipp Medical Group, Inc

• Marriage & Family Therapist in Glendora, CA
• Providers in Glendora, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.