DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: THORA PETERSEN

MEDICARE: THORA PETERSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1790637171
Entity Type Code : Individual
Provider Name (Legal Business Name) : THORA PETERSEN
Provider Business Mailing Address
First Line : 100 N PACIFIC COAST HWY STE 1400
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-5602
Country : US
Telephone Number : 949-357-2556
Fax Number : 949-357-2556
Provider Business Practice Location Address
First Line : 7806 UPLANDS WAY STE A
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-7567
Country : US
Telephone Number : 916-632-1330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

Similar Medicare Providers

1275485617 — MARYAM ISMAEL
Practice Location Address:
7806 UPLANDS WAY STE A
CITRUS HEIGHTS, CA
95610-7567
Practice Phone: 916-632-1330
Practice Fax:
1114879566 — MAYA BLACKLOCK
Practice Location Address:
7806 UPLANDS WAY STE A
CITRUS HEIGHTS, CA
95610-7567
Practice Phone: 916-632-1330
Practice Fax:
1356293708 — GISELLE ANDRADE
Practice Location Address:
7806 UPLANDS WAY STE A
CITRUS HEIGHTS, CA
95610-7567
Practice Phone: 916-632-1330
Practice Fax:
1871445239 — KELIA CAMPOS
Practice Location Address:
7806 UPLANDS WAY STE A
CITRUS HEIGHTS, CA
95610-7567
Practice Phone: 916-632-1330
Practice Fax:
1134071509 — AVA LOR
Practice Location Address:
7806 UPLANDS WAY STE A
CITRUS HEIGHTS, CA
95610-7567
Practice Phone: 916-632-1330
Practice Fax:
1831041227 — CASANDRA MENDOZA VARGAS
Practice Location Address:
7806 UPLANDS WAY STE A
CITRUS HEIGHTS, CA
95610-7567
Practice Phone: 916-632-1330
Practice Fax:

Directions to “ THORA PETERSEN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.