Basic Information
| Provider Information | |||||||||
| NPI: | 1013561844 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEHR | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | HOWELL | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 161 TAMALPAIS RD | ||||||||
| Address2: | |||||||||
| City: | FAIRFAX | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949301521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155052477 | ||||||||
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| Practice Location | |||||||||
| Address1: | 234 N SAN PEDRO RD | ||||||||
| Address2: | |||||||||
| City: | SAN RAFAEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949032858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154793450 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2019 | ||||||||
| LastUpdateDate: | 09/10/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 20428 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.