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General NPI Number Information
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NPI Number | 1275762908
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Entity Type | Individual
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Provider Name | PETER STOCKS M.S., MFT
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Gender | Male
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 27851 BRADLEY RD STE 108
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City | MENIFEE
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State | CA
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Zip | 92586-2213
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Country | US
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Telephone | 951-419-5138
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 557
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City | WILDOMAR
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State | CA
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Zip | 92595-0557
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Country | US
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Telephone | 951-212-5423
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 53208
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License Number State | CA
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