Provider Demographics
NPI:1548389620
Name:CALDWELL, PETER (MS,MFT)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:MS,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 JEANETTE CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5914
Mailing Address - Country:US
Mailing Address - Phone:925-352-5251
Mailing Address - Fax:
Practice Address - Street 1:4415 COWELL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1997
Practice Address - Country:US
Practice Address - Phone:925-685-0207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28937106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist