Angela Petersen, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

8950 Villa la Jolla Dr Ste B109
La Jolla, CA 92037-1704

Phone

(808) 927-7049

NPI assigned

May 24, 2016

Last updated

Apr 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rooted in Change, LLC

  • Community/Behavioral Health Agency
  • Missoula, MT
  • NPI 1912775065
  NPD Authorized official

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1831547496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE B109",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371704",
            "telephone_number": "808-927-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 VILLA LA JOLLA DR STE B109",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371704",
            "telephone_number": "808-927-7049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2310 Parmenter St",
            "address_2": "Apt. #320",
            "address_purpose": "LOCATION",
            "city": "Middleton",
            "state": "WI",
            "postal_code": "535622608",
            "country_code": "US",
            "telephone_number": "808-927-7049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur C Perry, MD
• Perry, Pratt, & Coden , a Medical Corporation
• Jan Pertschuk, N.P.
• Ashley Pester
• Peter Mann MD Inc
• Kirk L Peterson, M.D.
• McKayla Peterson
• Rachel Peterson, CERTIFIED MASSAGE
• Shadi Pezeshki
• Danika Drue Pflueger

• Psychologist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.