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NPI Code Detail

MEDICARE: SIDNEY PETERS

MEDICARE: SIDNEY PETERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1417804816
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIDNEY PETERS
Provider Business Mailing Address
First Line : 2550 N HOLLYWOOD WAY STE 301
Second Line :
City : BURBANK
State : CA
Zip : 91505-5025
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 34475 MOUND RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-5761
Country : US
Telephone Number : 844-263-1613
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2026
Last Update Date : 03/13/2026

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Directions to “ SIDNEY PETERS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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