Provider Demographics
NPI:1033410683
Name:CHALLENOR, PETER CLAYTON (RN, LAC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:CLAYTON
Last Name:CHALLENOR
Suffix:
Gender:M
Credentials:RN, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BELSHAW ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-2609
Mailing Address - Country:US
Mailing Address - Phone:925-755-7000
Mailing Address - Fax:925-755-7007
Practice Address - Street 1:2 BELSHAW ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-2609
Practice Address - Country:US
Practice Address - Phone:925-755-7000
Practice Address - Fax:925-755-7007
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-14
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4247171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist