Doctor Name: | PETER SHUM |
NPI Number: | 1386002707 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MFTI |
License Number: | 2557 |
Business Practice Address: | 1050 Shell Blvd #4541 Foster City, CA - 944042983 |
Business Phone Number: | 4088874149 |
Business Fax Number: | |
Mailing Address: | Po Box 4541, FOSTER CITY |
State: | CA |
Postal Code: | 944040541 |
Phone Number: | 4088874149 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2016 |
NPI Last Update Date: | 01/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2557 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |