Provider Demographics
NPI:1578859922
Name:BINNS, PEGGY ANN
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:ANN
Last Name:BINNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21462 OUTLOOK CT
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-6220
Mailing Address - Country:US
Mailing Address - Phone:510-582-2637
Mailing Address - Fax:
Practice Address - Street 1:21462 OUTLOOK CT
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-6220
Practice Address - Country:US
Practice Address - Phone:510-582-2637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)