Healthcare Provider Details

I. General information

NPI: 1467298174
Provider Name (Legal Business Name): PEER PROFESSIONALS OF CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 HOLLY DR STE B
SAN DIEGO CA
92113-2047
US

IV. Provider business mailing address

78 COUNTRY CLUB CIR
CHULA VISTA CA
91911-2259
US

V. Phone/Fax

Practice location:
  • Phone: 619-292-9490
  • Fax: 619-915-6892
Mailing address:
  • Phone: 619-732-9972
  • Fax: 619-915-6892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ROBERT TALMON FORTE
Title or Position: CEO
Credential: CPPS
Phone: 619-732-9772