Individual provider Active NPI

Gayle Marie Peterson, NP

  • Occupational Health Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1215059753
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health Nurse PractitionerTaxonomy code 363LX0106X
License
483597 Issued in CA
Practice address
8695 Spectrum Center Blvd
San Diego, CA 92123-1489
Phone
(858) 499-5259
Fax
(858) 499-5317
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Nurse Practitioner 363LX0106X 483597 CA Primary

Addresses

Primary practice location

8695 Spectrum Center Blvd
San Diego, CA 92123-1489

Mailing address

18160 Sencillo Dr
San Diego, CA 92128-1325
Phone (858) 451-3787

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
483597CAMDOccupational Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215059753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18160 SENCILLO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921281325",
            "telephone_number": "858-451-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8695 SPECTRUM CENTER BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231489",
            "telephone_number": "858-499-5259",
            "fax_number": "858-499-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "GAYLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "CA",
            "license": "483597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • 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.