Jacquene J Richardson

NPI 1053699850 - Licensed Psychiatric Technician - 167G00000X

NPI Details
NPI 1053699850
Gender Female
Enumeration Date 07/27/2011
Last Updated 08/01/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
3875 S WESTERN AVE
LOS ANGELES CA, 90062-1105, US
Phone (323) 290-4373
Fax
Business Location
498 W. 59TH STREET
SAN BERNARDINO CA, 92407, US
Phone (323) 290-4373
Fax
Toxanomy
Taxonomy Code 167G00000X
License State California
License Number PT36012
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According to our database, Mrs. Jacquene J Richardson NPI is 1053699850, taxonomy code is 167G00000X and license number is PT36012, license state is located at California. Jacquene J Richardson physically located at 3875 S Western Ave, Los Angeles CA, 90062-1105. NPI Number Jacquene J Richardson has the Individual type.

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1053699850 NPI number is provided on an as is basis without warranty of any kind. 1053699850 is maintained by the National Plan & Provider Enumeration System. The contents of Jacquene J Richardson are for informational purposes only.