Michael Stephen Petersen, is a
Peer Specialist based in Concord, California. Michael Stephen Petersen is licensed to practice in California (license number MPSS-DWMIVN) and his current practice location is
2425 Bisso Ln Ste 100, Concord, California. He can be reached at his office (for appointments etc.) via phone at
(925) 500-3093.
NPI number for Michael Stephen Petersen is 1871257535 and his current mailing address is Po Box 21352, Concord, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1871257535.
Healthcare Provider's Profile
| Full Name | Michael Stephen Petersen |
|---|
| Gender | Male |
|---|
| Speciality | Peer Specialist |
|---|
| Location | 2425 Bisso Ln Ste 100, Concord, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1871257535
- Provider Enumeration Date: 10/28/2021
- Last Update Date: 04/15/2024
Medical Identifiers
Medical identifiers for Michael Stephen Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871257535 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (California) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
| 175T00000X | Peer Specialist | MPSS-DWMIVN (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michael Stephen Petersen is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Michael Stephen Petersen,
Po Box 21352,
Concord, CA 94521-0352
Ph: (925) 826-9640 | Michael Stephen Petersen,
2425 Bisso Ln Ste 100,
Concord, CA 94520-4817
Ph: (925) 500-3093 |
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