Healthcare Provider Details

I. General information

NPI: 1043644875
Provider Name (Legal Business Name): PETER SCHEUFELE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 GRANT RD ECH 133
MOUNTAIN VIEW CA
94040-4302
US

IV. Provider business mailing address

939 ROBIN WAY
SUNNYVALE CA
94087-1522
US

V. Phone/Fax

Practice location:
  • Phone: 650-988-8328
  • Fax: 650-988-7833
Mailing address:
  • Phone: 408-530-8821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20795
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: