Richard Ettelson in Rancho Cucamonga - Clinical
Richard Ettelson - NPI 1174569453
Richard Ettelson is a Clinical in Rancho Cucamonga, California. Richard Ettelson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Richard Ettelson is 1174569453. The last update date is 2018-09-18.
Richard Ettelson's current location address is 10630 Town Center Dr Ste 120, Rancho Cucamonga, California. You can contact this provider via phone number 9099890901 and fax number 9099411087. The mailing address for Richard Ettelson is 10630 Town Center Dr Ste 120, Rancho Cucamonga, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Richard Ettelson |
|---|---|
| Address | 10630 Town Center Dr Ste 120, Rancho Cucamonga, California |
| Phone Number | 9099890901 |
| Fax Number | 9099411087 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1174569453 |
|---|---|
| Provider Enumeration Date | 2006-06-22 |
| Last Updated Date | 2018-09-18 |
Provider Mailing Address Detail
| Address | 10630 Town Center Dr Ste 120 |
|---|---|
| City | Rancho Cucamonga |
| State | California (CA) |
| Post Code | 917306889 |
| Phone Number | 9099890901 |
| Fax Number | 9099411087 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | D5418953 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identification code issued to Richard Ettelson by the Centers for Medicare & Medicaid Services?
The Richard Ettelson has been assigned the NPI (National Provider Identifier) 1174569453 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Richard Ettelson's facilities are geographically located?
The facilities of Richard Ettelson are physically situated at the following location: 10630 Town Center Dr Ste 120, Rancho Cucamonga, CA, 917306889.
What is Richard Ettelson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Richard Ettelson is Clinical, and the taxonomy classification code that categorizes this area of expertise is 103Tc0700X.
When did Richard Ettelson receive its 1174569453 assignment?
The Richard Ettelson was assigned its 1174569453 on 2006-06-22, which is the date when this unique identifier was issued to the organization.
When was the information related to Richard Ettelson most recently updated or refreshed?
The details pertaining to the Richard Ettelson, including its address, specialty, and other relevant information, were last updated or refreshed on 2018-09-18.