Healthcare Provider Details

I. General information

NPI: 1710707005
Provider Name (Legal Business Name): RIKKI L GLANTZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216B ELM LN
LOMPOC CA
93436-2727
US

IV. Provider business mailing address

216B ELM LN
LOMPOC CA
93436-2727
US

V. Phone/Fax

Practice location:
  • Phone: 415-244-8269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number138597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: