Provider Demographics
NPI:1225349905
Name:PETERSON, MARSHA KAY (MS)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:KAY
Last Name:PETERSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARSI
Other - Middle Name:KAY
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:1236 CHAPALA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3116
Mailing Address - Country:US
Mailing Address - Phone:805-965-2376
Mailing Address - Fax:
Practice Address - Street 1:1236 CHAPALA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3116
Practice Address - Country:US
Practice Address - Phone:805-965-2376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor