Dr. Peter Robert Libero
Psychologist Health Service Clinical Psychologist
4180 La Jolla Village Dr Ste 550a
La Jolla
, California 92037-1402
Dr. Peter Robert Libero
Psychologist Health Service Clinical Psychologist
4180 La Jolla Village Dr Ste 550a
La Jolla
, California 92037-1402
(858) 455-1862
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About
Features
Specialties
- Psychologist
- Clinical Psychologist
- Health Service
Languages spoken
- English
Location
First Address
- Dr. Peter Robert Libero
- 4180 La Jolla Village Dr Ste 550a
- La Jolla, CA
- Zip : 92037-1402
- Fax : (858) 455-1862
- Phone : (858) 453-1596
Second Address
- Dr. Peter Robert Libero
- 4180 La Jolla Village Dr Ste 550a
- La Jolla, CA
- Zip : 92037-1402
- Fax : (858) 455-1862
- Phone : (858) 453-1596
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | PSY8841 | CA |
| N | 103T00000X | Psychologist | PSY8841 | CA |
| Y | 103G00000X | Clinical Psychologist | PSY8841 | CA |
| Y | 103TC0700X | Clinical Psychologist | PSY8841 | CA |
| N | 103TH0100X | Health Service | PSY8841 | CA |
National Provider Identifier
| NPI | 1205983061 |
|---|---|
| Provider Name | Dr. Peter Robert Libero |
| First Address | La Jolla, CA 92037-1402 |
| Second Address | La Jolla, CA 92037-1402 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/01/2007 |
| Last Update Date | 16/10/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| R62346 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.