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General NPI Number Information
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NPI Number | 1396894762
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Entity Type | Individual
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Provider Name | JONI PETERSEN R.N.
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8038 LAUREL PARK CIR
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City | RIVERSIDE
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State | CA
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Zip | 92509-4096
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Country | US
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Telephone | 951-360-1816
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Fax | 951-360-1874
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Provider Business Mailing Address
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Address Line | 8038 LAUREL PARK CIR
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City | RIVERSIDE
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State | CA
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Zip | 92509-4096
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Country | US
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Telephone | 951-360-1816
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Fax | 951-360-1874
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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 | 430092
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 430092
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 430092
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 430092
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 430092
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License Number State | CA
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