Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY13995 | CA |
Y | 103T00000X | Psychologist | PSY13995 | CA |
NPI | 1003995598 |
---|---|
Provider Name | Dr. Robert William Richey |
First Address | San Luis Obispo, CA 93401-7680 |
Second Address | Santa Maria, CA 93455-3620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 08/07/2007 |