Provider Demographics
NPI:1891685525
Name:PETERS, JONAH MONIQUE
Entity type:Individual
Prefix:
First Name:JONAH
Middle Name:MONIQUE
Last Name:PETERS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7582 ROCK CREST LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3975
Mailing Address - Country:US
Mailing Address - Phone:951-284-5980
Mailing Address - Fax:
Practice Address - Street 1:7582 ROCK CREST LN
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-3975
Practice Address - Country:US
Practice Address - Phone:951-284-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist