Provider Demographics
NPI:1891959474
Name:REEDY, PETER ARNOLD
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:ARNOLD
Last Name:REEDY
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 1:1900 E LA PALMA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-1636
Mailing Address - Country:US
Mailing Address - Phone:714-399-3480
Mailing Address - Fax:714-399-3481
Practice Address - Street 1:1900 E LA PALMA AVE STE 101
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-1636
Practice Address - Country:US
Practice Address - Phone:714-399-3480
Practice Address - Fax:714-399-3481
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health