Healthcare Provider Details

I. General information

NPI: 1962608257
Provider Name (Legal Business Name): PETER HOWARD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 SACRAMENTO ST
SAN FRANCISCO CA
94118-1734
US

IV. Provider business mailing address

3610 SACRAMENTO ST
SAN FRANCISCO CA
94118-1734
US

V. Phone/Fax

Practice location:
  • Phone: 415-346-8862
  • Fax: 415-461-7920
Mailing address:
  • Phone: 415-346-8862
  • Fax: 415-461-7920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY8543
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY8543
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY8543
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY8543
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY8543
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: