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General NPI Number Information
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NPI Number | 1245635515
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Entity Type | Individual
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Provider Name | SALISHA PETERS R.N.
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Gender | Female
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 1253 PASEO AZUL WAY
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City | CORONA
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State | CA
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Zip | 92879-8503
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Country | US
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Telephone | 951-710-0033
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Fax |
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Provider Business Mailing Address
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Address Line | 1253 PASEO AZUL WAY
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City | CORONA
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State | CA
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Zip | 92879-8503
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Country | US
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Telephone | 951-710-0033
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 640665
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 640665
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 640665
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 640665
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 640665
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 640665
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License Number State | CA
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