Provider Demographics
NPI:1750150322
Name:PECK, DEVIN SEAN (LPCC TRAINEE)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:SEAN
Last Name:PECK
Suffix:
Gender:M
Credentials:LPCC TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 POLE LINE RD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-1360
Mailing Address - Country:US
Mailing Address - Phone:714-469-2146
Mailing Address - Fax:
Practice Address - Street 1:3090 FITE CIR STE 102
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1810
Practice Address - Country:US
Practice Address - Phone:916-701-5197
Practice Address - Fax:724-648-3486
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health