Leslie Petersen, N.P.

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

21870 Issued in CA

Practice address

268 Village Commons Blvd Unit 19
Camarillo, CA 93012-6828

Phone

(423) 313-8812

NPI assigned

Apr 16, 2014

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

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1992125082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 VILLAGE COMMONS BLVD UNIT 19",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930126828",
            "telephone_number": "423-313-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 VILLAGE COMMONS BLVD UNIT 19",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930126828",
            "telephone_number": "423-313-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "LESLIE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "21870",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP21870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Williams Persons, DDS
• Peter Chirico
• Peter Ro, MD, Professional Corporation
• Jeremiah Peters, FNP
• Kimberly Scott Peters, D.C.
• Holly Peterson
• Roger Martin Peterson, DDS
• Susan Petro
• Dobrinia Evdokiya Petrov
• Julie Ann Petyak-Ryan, L.AC.

• Acute Care Nurse Practitioner in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.