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NPI Code Detail

MEDICARE: JOCELYN PETERSON

MEDICARE: JOCELYN PETERSON
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 TechnicianCA

General Provider Information

NPI Number : 1205771565
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOCELYN PETERSON
Provider Business Mailing Address
First Line : 233 CALIFORNIA ST APT B
Second Line :
City : SANTA PAULA
State : CA
Zip : 93060-5608
Country : US
Telephone Number : 805-200-0337
Fax Number :
Provider Business Practice Location Address
First Line : 7422 GARVEY AVE UNIT 204
Second Line :
City : ROSEMEAD
State : CA
Zip : 91770-2974
Country : US
Telephone Number : 626-531-6999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2026
Last Update Date : 04/22/2026

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Directions to “ JOCELYN PETERSON ” Practice Location

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