Provider Demographics
NPI:1598222069
Name:CELLARIUS, PETER (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:CELLARIUS
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6591 LITTLE FALLS DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-4050
Mailing Address - Country:US
Mailing Address - Phone:408-460-5000
Mailing Address - Fax:
Practice Address - Street 1:319 LOS GATOS SARATOGA RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5310
Practice Address - Country:US
Practice Address - Phone:408-831-2974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist