| Doctor Name: | RONALD LEON PETERIS |
| NPI Number: | 1477705226 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | LCSW#4525 |
| Business Practice Address: | 29300 The Old Rd Jmet-boq2 Castaic, CA - 913842905 |
| Business Phone Number: | 6612946331 |
| Business Fax Number: | 6612959340 |
| Mailing Address: | 29300 The Old Rd, Jmet-boq2 CASTAIC |
| State: | CA |
| Postal Code: | 913842905 |
| Phone Number: | 6612946331 |
| Fax Number: | 6612959340 |
| NPI Enumeration Date: | 10/10/2008 |
| NPI Last Update Date: | 10/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW#4525 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |