Chad Peterson, RNFA

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

775942 Issued in CA

Practice address

3300 Webster St Ste 500
Oakland, CA 94609-3149

Phone

(510) 465-6600

Fax

(510) 839-0806

NPI assigned

Mar 30, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1972181238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST STE 500",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093149",
            "telephone_number": "510-465-6600",
            "fax_number": "510-839-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 WEBSTER ST STE 500",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093149",
            "telephone_number": "510-465-6600",
            "fax_number": "510-839-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CHAD",
        "credential": "RNFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "CA",
            "license": "775942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RNMFA",
            "identifier": "775942",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cspeterson9187@sbcglobal.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure e-mail",
            "address_1": "3300 Webster St Ste 500",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946093149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Scott J. Petersen, MD
• Sidney Petersen, RN
• Audrey Lauren Peterson, D.D.S.
• Ayannah Nichole Peterson
• Caroline Alston Peterson, D.M.D.
• Dagnija M Peterson, P.T.
• Ellen Tanner Peterson, RN, CPNP, MSN
• Janis Marie Peterson
• Kay Peterson, LMFT
• Michael Alex Peterson, PH.D.

• Medical-Surgical Registered Nurse in Oakland, CA
• Providers in Oakland, CA by specialty
• Medical-Surgical Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.