MR. PETER VAUGHN SULLIVAN (NPI# 1871895870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871895870 |
| Entity Type | Individual |
| Full Name | MR. PETER VAUGHN SULLIVAN |
| Practice Address |
4020 Civic Center Dr San Rafael CA 94903-4173 |
| Practice Telephone | 4154912566 |
| Practice Fax Number | 4154722186 |
| Mailing Telephone | 4154912566 |
| Mailing Fax Number | 4154722186 |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2015-08-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407071194 | Peter E Sullivan | Counselor | 44 Myrtle Ter, Winchester, MA 01890-3157 | 2007-04-16 |
| 1558468322 | Peter Damian Sullivan | Hospitalist | 3181 Sw Sam Jackson Park Rd # Bte119, Portland, OR 97239-3011 | 2006-09-20 |
| 1992320857 | Peter Sullivan | Student in an Organized Health Care Education/Training Program | 1500 Lansdowne Ave, Darby, PA 19023-1200 | 2020-06-16 |
| 1538664016 | Peter Sullivan | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2018-03-27 |
| 1306292024 | Peter Sullivan | Anesthesiology | Kumc 3901 Rainbow Blvd Ms 1034, Kansas City, KS 66160-0001 | 2016-05-12 |
| 1205201688 | Peter Joshua Sullivan | Social Worker | 5500 Armstrong Rd, Battle Creek, MI 49037-7314 | 2015-12-10 |
| 1225439300 | Peter Sullivan | Pharmacist | 1275 York Ave, New York, NY 10065-6007 | 2014-09-09 |
| 1235399221 | Peter David Sullivan | Occupational Therapist | 1115 Capitola Rd, Santa Cruz, CA 95062-2844 | 2008-06-12 |
| 1578603478 | Peter D Sullivan | Emergency Medicine | 7007 Powers Blvd, Parma, OH 44129-5437 | 2007-02-08 |
| 1437250412 | Peter J Sullivan | Physician Assistant | 927 Franklin St Se, The Orthopaedic Center, Huntsville, AL 35801-4306 | 2006-09-25 |
| Street Address |
4020 CIVIC CENTER DR |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-4173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902910342 | Gail Mosconi | Social Worker | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2006-08-19 |
| 1770120107 | Amy Bower | Counselor | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2019-12-04 |
| 1205306750 | Kathleen Marie Moran | Counselor | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2018-11-27 |
| 1871016931 | Keyanna Rene Learson | Rehabilitation Practitioner | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2017-07-20 |
| 1972026425 | Deborah Ruth Berenboim | Rehabilitation Practitioner | 4020 Civic Center Dr, San Rafael, CA 94903 | 2017-07-17 |
| 1568911816 | Dana Perez | Rehabilitation Practitioner | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2016-09-28 |
| 1629439708 | Samantha Guzowski | Counselor | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2016-03-16 |
| 1689035750 | Kimberly Carroll | Counselor | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2016-03-16 |
| 1588024608 | Aaron Magee | Counselor | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2016-03-02 |
| 1497115034 | Jennifer Andrade | Counselor | 4020 Civic Center Dr, San Rafael, CA 94903-4173 | 2016-02-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1548789464 | Michael Robins | Counselor | 1401 Los Gamos Dr # 204, San Rafael, CA 94903-1809 | 2017-09-12 |
| 1912431271 | Community Action Marin | Counselor | 3207 Kerner Boulebvard, San Rafael, CA 94901-3507 | 2017-04-13 |
| 1871047597 | Joseph Dela Vega | Counselor | 361 3rd St Ste B, San Rafael, CA 94901-3580 | 2016-08-10 |
| 1588117808 | Jessica Noelle Panoski | Counselor | 1403 Los Gamos, San Rafael, CA 95403 | 2016-08-03 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1194149260 | Kathryn Harrison Solana | Counselor | 3100 Kerner Blvd Ste C1, San Rafael, CA 94901-5445 | 2014-02-10 |
| 1588904403 | Jose Alfredo Escobar | Counselor | 1 St. Vincent Drive, San Rafael, CA 94903 | 2013-03-01 |
| 1508126939 | Amit Singh | Counselor | 7 Le Claire Ct, San Rafael, CA 94903-3526 | 2012-05-18 |
| 1316211311 | Denia C Briggs | Counselor | 1 Saint Vincents Drive, San Rafael, CA 94903-1504 | 2012-03-08 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
Please comment or provide details below to improve the information on MR. PETER VAUGHN SULLIVAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.