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General NPI Number Information
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NPI Number | 1538280854
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Entity Type | Individual
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Provider Name | MARION MACPHAIL PETERSON RN MFT
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1756 LACASSIE AVENUE SUITE 200
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City | WALNUT CREEK
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State | CA
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Zip | 94596-7002
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Country | US
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Telephone | 925-933-8300
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Fax | 510-843-0276
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Provider Business Mailing Address
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Address Line | 1756 LACASSIE AVENUE SUITE 200
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City | WALNUT CREEK
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State | CA
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Zip | 94596-7002
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Country | US
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Telephone | 925-933-8300
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Fax | 510-843-0276
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 32921
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN 233108
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License Number State | CA
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