Candice Diane Peterson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

902 Tuolumne St
Vallejo, CA 94590-4641

Phone

(707) 648-8121

NPI assigned

Oct 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Southern California Keck School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mood Clinical, P. C.Group PAC ID 4981080769, 107 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Mood Clinical, P. C.

  • Adult Mental Health Clinic/Center
  • Santa Ana, CA
  • NPI 1922675644
  Medicare reassignment Care Compare group NPD
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238
  Medicare reassignment NPD
• Dynamic Psychotherapy Center Inc

  • Clinical Psychologist
  • Torrance, CA
  • NPI 1811651797
  NPD
• Glenn Medical Center, LLC

  • Critical Access Hospital
  • Willows, CA
  • NPI 1619929759
  NPD (past)

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1992956379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1972 MAYBELLE DR",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945232708",
            "telephone_number": "925-798-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 TUOLUMNE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904641",
            "telephone_number": "707-648-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CANDICE",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Permanente Medical Group Inc
• Soren Perry
• Carine D Peters, CMT
• Sarah Peters
• Allisen Peterson
• Michael W Peterson, DDS
• Snow Peterson, DO, MS
• Stephanie M. Peterson, MD
• Sarah Petrie, DO
• Anne Marie Pettibone, CRNA

• Mental Health Counselor in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.