Ashlee Petersen, CADC I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CI25040518 Issued in CA

Practice address

12301 Wilshire Blvd Ste 206
Los Angeles, CA 90025-1000

Phone

(310) 487-2029

NPI assigned

Mar 7, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Integrity Treatment Program, LLC

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1619333002
  NPD (past)

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1942768064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43518 CARPENTER DR",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354882",
            "telephone_number": "310-487-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD STE 206",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251000",
            "telephone_number": "310-487-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ASHLEE",
        "credential": "CADC I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "CI25040518",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI25040518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy L Peters
• Stefanie Doyle Peters, PH.D.
• Tiffany Lajaun Peters
• Tom C Peters, LCSW
• Petersen Holdings Inc.
• Celia Santana Petersen, LCSW
• Guy Petersen
• Jeffrey Ming Petersen, MD
• John Devin Petersen, M.D.
• Jopeth Pahilanga Petersen, LMFT

• Addiction (Substance Use Disorder) Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.