Provider Demographics
NPI:1770072423
Name:PEOPLES, TRE'VON RASHAD
Entity type:Individual
Prefix:
First Name:TRE'VON
Middle Name:RASHAD
Last Name:PEOPLES
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 1:377 SOMERSET HILLS GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-1479
Mailing Address - Country:US
Mailing Address - Phone:858-610-1418
Mailing Address - Fax:
Practice Address - Street 1:1325 STANISLAUS DR
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-1403
Practice Address - Country:US
Practice Address - Phone:858-610-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA118240106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program