Phillip E Peters, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0-15-6538 Issued in CA

Practice address

1550 Hotel Cir N
Suite#450
San Diego, CA 92108-2901

Phone

(619) 692-1581

Fax

(619) 692-1588

NPI assigned

Apr 6, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Communication Lab Family Services

  • Speech-Language Pathologist
  • San Diego, CA
  • NPI 1598492837
  NPD Authorized official
• Communication Lab LLC

  • Behavior Analyst
  • San Diego, CA
  • NPI 1518519933
  NPD Authorized official
• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1740675867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 PESCADERO AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073537",
            "telephone_number": "310-961-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 HOTEL CIR N",
            "address_2": "SUITE#450",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082901",
            "telephone_number": "619-692-1581",
            "fax_number": "619-692-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "PHILLIP",
        "middle_name": "E",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "0-15-6538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "W416",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Joanne Peters
• Lily Peters, MD
• Mairead Peters
• Melissa Ann Peters, RN
• Michael Peters
• Richard M. Peters Jr., MD
• Robert E Peters, PHD, M.D
• Sage Ainsley Peters, RBT
• Tatiana Anna Peters
• Tonye Peters

• Behavior Analyst in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.

Verify at the official NPI Registry.