Active NPI
Peter Goldie, B.S.
- Behavior Technician
- San Mateo, CA
National Provider Identifier
1265092118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 424 Peninsula Ave
San Mateo, CA 94401-1653 - Phone
- (650) 286-4396
- NPI assigned
- Jun 13, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
424 Peninsula Ave
San Mateo, CA 94401-1653
Mailing address
4220 Ruthelma Ave
Palo Alto, CA 94306-4109
Phone (650) 248-8391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1265092118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4220 RUTHELMA AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943064109",
"telephone_number": "650-248-8391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 PENINSULA AVE",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944011653",
"telephone_number": "650-286-4396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDIE",
"first_name": "PETER",
"credential": "B.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-13",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.