Provider Demographics
NPI:1275762908
Name:STOCKS, PETER (MS, MFT)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:STOCKS
Suffix:
Gender:M
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 557
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-0557
Mailing Address - Country:US
Mailing Address - Phone:951-212-5423
Mailing Address - Fax:
Practice Address - Street 1:27851 BRADLEY RD STE 108
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586-2213
Practice Address - Country:US
Practice Address - Phone:951-419-5138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53208106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist