Provider Demographics
NPI:1700037991
Name:KEHOE, PETER A (LMFT)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:A
Last Name:KEHOE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 BOYSEA DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-1901
Mailing Address - Country:US
Mailing Address - Phone:408-978-0722
Mailing Address - Fax:
Practice Address - Street 1:1360 BOYSEA DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-1901
Practice Address - Country:US
Practice Address - Phone:408-978-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT38880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist