Michele Lee Peterson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

309873-3501 Issued in UT

Practice address

27349 Jefferson Ave Ste 102
Temecula, CA 92590-5611

Phone

(619) 354-3812

NPI assigned

Aug 27, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1125100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1275526980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29970 TECHNOLOGY DR STE 216",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632649",
            "telephone_number": "619-354-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27349 JEFFERSON AVE STE 102",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905611",
            "telephone_number": "619-354-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHELE",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-27",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "73177",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "309873-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "281460238",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA, QUEST, AND TRI-CARE",
            "identifier": "0000252015",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SimplePractice.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "24329 Bay Laurel Ave",
            "city": "Murrieta",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925622163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SimplePractice.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "24329 Bay Laurel Ave",
            "city": "Murrieta",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925622163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Garrett Ray Petersen, MD
• Abigail Elaine Peterson
• Amalia Peterson
• Emily Marie Peterson, PTA
• Gary Peterson, PA
• Robert G Peterson, M.D.
• Hunter Pfeiffer
• Cheryl Ann Pfent, PSYD
• Edward Pfund
• Christine Dinh Pham

• Clinical Social Worker in Temecula, CA
• Providers in Temecula, 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 Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.