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General NPI Number Information
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NPI Number | 1881906261
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Entity Type | Individual
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Provider Name | PETER ALLEN BROWN PSYD, MA
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Gender | Male
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 550 H ST STE 5N
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City | CRESCENT CITY
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State | CA
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Zip | 95531-3737
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Country | US
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Telephone | 415-375-0096
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6892
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City | BROOKINGS
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State | OR
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Zip | 97415-0351
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Country | US
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Telephone | 415-375-0096
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | PSY26174
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | 26174
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY#26174
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License Number State | CA
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