Susan Yvonne Peterson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8474 Issued in CA

Practice address

10730 Henderson Rd
Ventura, CA 93004-1832

Phone

(805) 647-1141

NPI assigned

Oct 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Susan Yvonne Baker Former name

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": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1225313679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 CAMINO CALANDRIA",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604534",
            "telephone_number": "805-493-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 HENDERSON RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041832",
            "telephone_number": "805-647-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SUSAN",
        "middle_name": "YVONNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "8474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BAKER",
            "middle_name": "YVONNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dane K Petersen, NP
• Jennifer K Peterson
• Kaylee Peterson, M.S., PPA
• Margaret Ann Peterson, MD
• Nicholas Edward Peterson, MD
• Melissa Petitt
• Jacqueline Petris, RBT
• Sarah Bethany Petrisin, MSED, ATC, NCMT
• Jeffrey J. Petron, D.D.S.
• Petros K. Frousiakis, D.O., a Professional Corporation

• Speech-Language Pathologist in Ventura, CA
• Providers in Ventura, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.