Provider Demographics
NPI:1932641156
Name:FLORES, PETER
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:FLORES
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 1:2550 W CLINTON AVE
Mailing Address - Street 2:BUILDING B, #128
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705
Mailing Address - Country:US
Mailing Address - Phone:559-225-9117
Mailing Address - Fax:
Practice Address - Street 1:FAMILY YOUTH ALTERNATIVES
Practice Address - Street 2:2550 W. CLINTON BUILDING B, #128
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705
Practice Address - Country:US
Practice Address - Phone:559-225-9117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)