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NPI Code Detail

MEDICARE: CARISSA ERIN PETERSON LMFT

MEDICARE: CARISSA ERIN PETERSON LMFT
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
1106H00000XMarriage & Family Therapist143667CA

General Provider Information

NPI Number : 1841817061
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARISSA ERIN PETERSON LMFT
Provider Business Mailing Address
First Line : 46883 MONROE ST
Second Line :
City : INDIO
State : CA
Zip : 92201-6768
Country : US
Telephone Number : 760-398-9000
Fax Number :
Provider Business Practice Location Address
First Line : 46883 MONROE ST
Second Line :
City : INDIO
State : CA
Zip : 92201-6768
Country : US
Telephone Number : 760-398-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2020
Last Update Date : 01/13/2026

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