Jennifer Paige Petersen, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27190 Issued in CA

Practice address

39 Quail CT Ste 205
Walnut Creek, CA 94596-5570

Phone

(925) 322-0166

NPI assigned

May 14, 2015

Last updated

May 14, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jennifer Paige Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1952789562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 QUAIL CT STE 205",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965570",
            "telephone_number": "925-322-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 QUAIL CT STE 205",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965570",
            "telephone_number": "925-322-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIGE PETERSEN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PAIGE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lei Angela Villanueva Paeste
• Helen Page
• Ann M. Pagliaro, LCSW
• Danielle Pai
• Jonathan Pai
• Daniel Young Paik, MD
• Wendy Paik, PSY.D.
• Lauren Pak
• Sheyda Pakkhoo
• Nick Sina Pakzad, M.D.

• Clinical Psychologist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.