| Candice Diane Peterson, | |
|
902 Tuolumne St, Vallejo, CA 94590-4641 | |
| (707) 648-8121 | |
| Not Available |
| Full Name | Candice Diane Peterson |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 12 Years |
| Location | 902 Tuolumne St, Vallejo, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992956379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mood Clinical, P. C. | 4981080769 | 60 |
| Entity Name | Mood Clinical, P. C. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922675644 PECOS PAC ID: 4981080769 Enrollment ID: O20220930002640 |
| Mailing Address | Practice Location Address |
|---|---|
| Candice Diane Peterson, 1972 Maybelle Dr, Pleasant Hill, CA 94523-2708 Ph: (925) 798-7191 | Candice Diane Peterson, 902 Tuolumne St, Vallejo, CA 94590-4641 Ph: (707) 648-8121 |
Leata Jeames, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2201 Tuolumne St, Vallejo, CA 94589 Phone: 707-558-1777 Fax: 707-558-1770 | |
Ned L Jacobs, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1017 Tennessee St, Vallejo, CA 94590 Phone: 707-647-1520 | |
Tiffany Marie Tyler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 908 Tuolumne St, Vallejo, CA 94590 Phone: 707-648-8121 Fax: 707-648-8129 | |
Michelle Reneta Ortiz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 126 Ohio St, Vallejo, CA 94590 Phone: 415-707-2577 Fax: 707-644-5501 | |
Tanesha Nixon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 627 Grant St, Vallejo, CA 94590 Phone: 707-553-1042 | |
Debra Marrama, PROGRAM DIRECTOR Counselor Medicare: Not Enrolled in Medicare Practice Location: 3467 Edgewater Pl, Vallejo, CA 94591 Phone: 707-732-8105 Fax: 707-667-0010 | |
Mr. Bjay Jones, Counselor Medicare: Not Enrolled in Medicare Practice Location: 236 Georgia Street, Vallejo, CA 94590 Phone: 510-229-2786 |