Jon Peterson Psychologist PHD PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

PSY6987 Issued in CA

Legal business name

JON PETERSON PSYCHOLOGIST PHD PC

Practice address

25401 Cabot Rd
Suite 213
Laguna Hills, CA 92653-5524

Phone

(949) 363-7386

Fax

(949) 276-2199

NPI assigned

Feb 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jon W Peterson, PH.D.NPI 1972549236

Title

Owner

Phone

(949) 363-7386

Specialties & licenses 1

Addresses

Other names 1

• Jon Peterson,PhD Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jon W Peterson, PHD

  • Clinical Psychologist
  • Laguna Hills, CA
  • NPI 1972549236
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233532800000",
    "number": "1396983128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25401 CABOT RD",
            "address_2": "SUITE 213",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535524",
            "telephone_number": "949-363-7386",
            "fax_number": "949-276-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25401 CABOT RD",
            "address_2": "SUITE 213",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535524",
            "telephone_number": "949-363-7386",
            "fax_number": "949-276-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON PETERSON PSYCHOLOGIST PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-02-02",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-363-7386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "PSY6987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jon Peterson,PhD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Elizabeth Johnson, FNP-C
• Meaghan C Johnson, OTR
• Susan Elizabeth Johnson, M.D.
• Taralyn Johnson, PA-C
• Elizabeth Ann Jolly
• Jonathan R Pirnazar M.D. a PC
• Anna Marie Jones
• Ashanti Jones
• Emily Elizabeth Jones
• Johnnae' Pearl Jones

• Mental Health Clinic/Center (Including Community Mental Health Center) in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.