Dr Mark Peterson, PSYD is a
Psychologist - Clinical based in Windsor, California. Dr Mark Peterson is licensed to practice in California (license number PSB94026068) and his current practice location is
8911 Lakewood Dr # 26a, Windsor, California. He can be reached at his office (for appointments etc.) via phone at
(916) 798-7072.
NPI number for Dr Mark Peterson is 1417600511 and his current mailing address is 9033 Acorn Ridge Cir, Elk Grove, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417600511.
Healthcare Provider's Profile
| Full Name | Dr Mark Peterson |
|---|
| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 8911 Lakewood Dr # 26a, Windsor, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1417600511
- Provider Enumeration Date: 01/28/2022
- Last Update Date: 01/28/2022
Medical Identifiers
Medical identifiers for Dr Mark Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417600511 | NPI | - | NPPES |
| 18611570000 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | PSB94026068 (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. Dr Mark Peterson 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 |
|---|
Dr Mark Peterson, PSYD
9033 Acorn Ridge Cir,
Elk Grove, CA 95758-5413
Ph: (916) 798-7072 | Dr Mark Peterson, PSYD
8911 Lakewood Dr # 26a,
Windsor, CA 95492-7856
Ph: (916) 798-7072 |
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