Healthcare Provider Details

I. General information

NPI: 1861524910
Provider Name (Legal Business Name): RICHILDA HARDY MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 09/12/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 SEPULVEDA BLVD
CULVER CITY CA
90230-4820
US

IV. Provider business mailing address

10654 PINYON AVE
TUJUNGA CA
91042-1559
US

V. Phone/Fax

Practice location:
  • Phone: 310-390-6612
  • Fax: 310-398-5690
Mailing address:
  • Phone: 818-398-6038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number44078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: