1306018940

Everything you always wanted to know about DR. PETERS EDWARD JOHN PHD but were afraid to ask.

DR. PETERS EDWARD JOHN PHD

You can also download the this 1306018940 data report as csv | excel | json | xml
Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
DR. PETERS EDWARD JOHN PHD
Gender:
Male
Enumeration date:
2008-03-24
Last update date:
2016-09-09
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
103TC0700X Clinical CA PSY 15056 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 5106651991
Mailing Address Fax Number 5106651991
Practice Location Address Telephone Number 8005482034
Practice Location Address Fax Number 8558495623

Addresses

Type Address City State Postal Country
Mailing Address 2124 KITTREDGE ST # 834 #5 BERKELEY CA 94704 CA
Practice Location Address 1035 SAN PABLO AVE ALBANY CA 94706 CA

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