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1023144573
KEITH R PETERSON
IRVINE, CA
NPI
1023144573
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA PSY 15859)
Enumeration Date
2007-02-26
Last Update Date
2007-07-08
Business Address
Dr. KEITH R PETERSON PhD
6 VENTURE SUITE 350
IRVINE, CA 92618-3340
Phone number: 949-683-8789
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Mailing Address
Dr. KEITH R PETERSON PhD
26741 PORTOLA PKWY SUITE 1E 432
FOOTHILL RANCH, CA 92610-1743
Phone number: 949-683-8789
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