Basic Information
| Provider Information | |||||||||
| NPI: | 1871766634 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLBETZ | ||||||||
| FirstName: | PETER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 444 WHISPERING PINES DR SPC 58 | ||||||||
| Address2: | |||||||||
| City: | SCOTTS VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950664752 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 484 OAK ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941025610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156265199 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2008 | ||||||||
| LastUpdateDate: | 07/21/2014 | ||||||||
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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 | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.