Individual
DR. GLENN ALLEN PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
16055 VENTURA BLVD STE 715, ENCINO, CA 91436-2610
(818) 475-2666
Mailing address
16055 VENTURA BLVD STE 715, ENCINO, CA 91436-2610
(818) 475-2666
(818) 783-0019
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 15757
CA
106H00000X
Marriage & Family Therapist
MFC 12865
CA
Other
Enumeration date
09/02/2006
Last updated
06/08/2021
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