Active NPI
Peter Pearson, PH.D
- Psychologist
- Menlo Park, CA
National Provider Identifier
1417168444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY6831
- Practice address
- 445 Burgess Dr
Suite #150
Menlo Park, CA 94025-3442 - Phone
- (650) 327-5915
- NPI assigned
- May 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY6831 | CA | Primary |
Addresses
Primary practice location
445 Burgess Dr
Suite #150
Menlo Park, CA 94025-3442
Mailing address
445 Burgess Dr
Suite #150
Menlo Park, CA 94025-3442
Phone (650) 327-5915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2016 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY6831 | CA | MD | Psychologist |
| 6831 | CA | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417168444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 BURGESS DR",
"address_2": "SUITE #150",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940253442",
"telephone_number": "650-327-5915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 BURGESS DR",
"address_2": "SUITE #150",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940253442",
"telephone_number": "650-327-5915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "PETER",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY6831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.