Healthcare Provider Details

I. General information

NPI: 1477616118
Provider Name (Legal Business Name): LINDA MARIE PETERSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S MAIN ST
WALNUT CREEK CA
94596-5318
US

IV. Provider business mailing address

835 W EL DORADO DR
WOODLAND CA
95695-5011
US

V. Phone/Fax

Practice location:
  • Phone: 925-295-5200
  • Fax: 925-295-5244
Mailing address:
  • Phone: 530-666-3666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number313383
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number328
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: