Healthcare Provider Details

I. General information

NPI: 1255637773
Provider Name (Legal Business Name): MR. FRANK LEE PEACE JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date: 04/23/2018
Reactivation Date: 11/07/2019

III. Provider practice location address

2031 HOWE AVE STE 200
SACRAMENTO CA
95825-0178
US

IV. Provider business mailing address

1350 BROADSTONE PKWY APT 3711
FOLSOM CA
95630-8483
US

V. Phone/Fax

Practice location:
  • Phone: 916-973-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number161689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: