Provider Demographics
NPI:1619830742
Name:KRAHLING, PETER WILLIAM
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:WILLIAM
Last Name:KRAHLING
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 1:3305 BUCKMAN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:PINE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91962-4005
Mailing Address - Country:US
Mailing Address - Phone:619-473-8601
Mailing Address - Fax:619-704-1623
Practice Address - Street 1:3305 BUCKMAN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:PINE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91962-4005
Practice Address - Country:US
Practice Address - Phone:619-473-8601
Practice Address - Fax:619-704-1623
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230249909101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty