Provider Demographics
NPI:1437381449
Name:KIRCHNER, PETER F (PHD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:F
Last Name:KIRCHNER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6238 KILGORD CT
Mailing Address - Street 2:
Mailing Address - City:MAGALIA
Mailing Address - State:CA
Mailing Address - Zip Code:95954-9630
Mailing Address - Country:US
Mailing Address - Phone:530-873-6743
Mailing Address - Fax:
Practice Address - Street 1:1507 21ST ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5220
Practice Address - Country:US
Practice Address - Phone:916-456-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22755103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical