Provider Demographics
NPI:1427582733
Name:PEACOR, LANCE
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:PEACOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2848 GRASSLANDS DR APT 1914
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-3531
Mailing Address - Country:US
Mailing Address - Phone:916-730-0612
Mailing Address - Fax:916-441-0286
Practice Address - Street 1:3780 ROSIN CT STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1698
Practice Address - Country:US
Practice Address - Phone:916-441-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor