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General NPI Number Information
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NPI Number | 1083780696
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Entity Type | Individual
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Provider Name | MR. PETER J MCCLURE
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 1885 LUNDY AVE
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City | SAN JOSE
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State | CA
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Zip | 95131-1887
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Country | US
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Telephone | 408-284-9039
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Fax |
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Provider Business Mailing Address
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Address Line | 5354 MAKATI CIR
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City | SAN JOSE
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State | CA
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Zip | 95123-6248
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Country | US
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Telephone | 510-415-5409
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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