Provider Demographics
NPI:1215146170
Name:PETERS, KARI RENEE' (MFT)
Entity type:Individual
Prefix:MS
First Name:KARI
Middle Name:RENEE'
Last Name:PETERS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MISS
Other - First Name:KARI
Other - Middle Name:RENEE'
Other - Last Name:ROSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:209 6TH STREET,
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901
Mailing Address - Country:US
Mailing Address - Phone:530-741-6275
Mailing Address - Fax:530-749-7913
Practice Address - Street 1:209 6TH STREET,
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901
Practice Address - Country:US
Practice Address - Phone:530-741-6275
Practice Address - Fax:530-749-7913
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42060106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist