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NPI Code Detail

MEDICARE: PEGGY ANNE HERMON CERTIFIED PEER

MEDICARE: PEGGY ANNE HERMON CERTIFIED PEER
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
1171M00000XCase Manager/Care Coordinator
2175T00000XPeer Specialist

General Provider Information

NPI Number : 1245366418
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEGGY ANNE HERMON CERTIFIED PEER
Provider Business Mailing Address
First Line : 3161 DWIGHT RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-6456
Country : US
Telephone Number : 916-427-7141
Fax Number : 916-427-7122
Provider Business Practice Location Address
First Line : 3161 DWIGHT RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-6456
Country : US
Telephone Number : 916-427-7141
Fax Number : 916-427-7122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2007
Last Update Date : 08/15/2023

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