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1104632991
KATRINA LAREA PETTERSEN
SAN JOSE, CA
NPI
1104632991
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TS0200X Psychologist, School
(Licence: CA 4489)
Enumeration Date
2024-12-05
Last Update Date
2024-12-19
Business Address
KATRINA LAREA PETTERSEN LEP 4489
1261 LINCOLN AVE STE 104
SAN JOSE, CA 95125-3030
Phone number: 408-439-1111
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Mailing Address
KATRINA LAREA PETTERSEN LEP 4489
2893 UNION AVE
SAN JOSE, CA 95124-1435
Phone number: 760-902-8990
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