Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Keith R Peterson, PHD

Individual provider Clinical Psychologist · NPI 1023144573

Dr. Keith R Peterson, PHD is a Clinical Psychologist in Irvine, California. Qualified in 1995, 31 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
31
Licensed in
CA
In the registry since
2007
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

6 Venture Ste 350
Irvine, CA 92618-3340
Phone: (949) 683-8789
Fax: (949) 581-4484
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY 15859 (CA)

Record details

NPI number1023144573
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedFebruary 26, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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