| Doctor Name: | KRISTINE A PETERSON |
| NPI Number: | 1053778993 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CDE |
| License Number: | RN798839 |
| Business Practice Address: | 1501 Trousdale Dr Fl 4 Burlingame, CA - 940104506 |
| Business Phone Number: | 6506528500 |
| Business Fax Number: | 6506528502 |
| Mailing Address: | 577 Airport Blvd Ste 300, BURLINGAME |
| State: | CA |
| Postal Code: | 940102048 |
| Phone Number: | 6502408198 |
| Fax Number: | |
| NPI Enumeration Date: | 01/22/2016 |
| NPI Last Update Date: | 01/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | RN798839 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |