Provider Demographics
NPI:1811884281
Name:PETERS, RONEAKA ANN (SUDRC #21780)
Entity type:Individual
Prefix:
First Name:RONEAKA
Middle Name:ANN
Last Name:PETERS
Suffix:
Gender:F
Credentials:SUDRC #21780
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 ELMWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-2820
Mailing Address - Country:US
Mailing Address - Phone:805-925-9695
Mailing Address - Fax:
Practice Address - Street 1:1933 ELMWOOD DR
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-2820
Practice Address - Country:US
Practice Address - Phone:805-925-9695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21780101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)