Provider Demographics
NPI:1912039975
Name:CALVO, PETER EUGENE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:EUGENE
Last Name:CALVO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 MAIN ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-5810
Mailing Address - Country:US
Mailing Address - Phone:541-850-9225
Mailing Address - Fax:541-273-7287
Practice Address - Street 1:905 MAIN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-5810
Practice Address - Country:US
Practice Address - Phone:541-850-9225
Practice Address - Fax:541-273-7287
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1625103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical