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General NPI Number Information
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NPI Number | 1467298174
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Entity Type | Organization
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Legal Business Name | PEER PROFESSIONALS OF CALIFORNIA
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 4181 RUFFIN RD STE 150
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City | SAN DIEGO
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State | CA
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Zip | 92123-1876
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Country | US
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Telephone | 619-292-9490
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Fax |
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Provider Business Mailing Address
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Address Line | 266 LANDIS AVE APT D
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City | CHULA VISTA
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State | CA
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Zip | 91910-2642
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Country | US
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Telephone | 619-732-9972
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT TALMON FORTE
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Credential | CPPS
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Telephone | 619-732-9772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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