Richard B. Addison, PHD
Individual provider Active NPI Psychologist · Santa Rosa, CA
NPI 1891817201 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1891817201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PSY 9035 (CA)
- Practice address
- 862 3Rd St
Santa Rosa, CA 95404-4529 - Phone
- (707) 576-9813
- NPI assigned
- Apr 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 9035 | CA | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 9035 | CA | Yes |
Addresses
Primary practice location
862 3Rd St
Santa Rosa, CA 95404-4529
Mailing address
862 3Rd St
Santa Rosa, CA 95404-4529
Phone (707) 576-9813
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- Patricia Adams
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All providers in Santa Rosa, CA · Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.