Provider Demographics
NPI:1235589896
Name:ARNOLD, PETER (PSYD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 W HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-6834
Mailing Address - Country:US
Mailing Address - Phone:559-288-8070
Mailing Address - Fax:
Practice Address - Street 1:4106 W HARVARD AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-6834
Practice Address - Country:US
Practice Address - Phone:559-288-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T0000X103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist