Healthcare Provider Details

I. General information

NPI: 1114175189
Provider Name (Legal Business Name): RICHA DUGGAL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E COLORADO BLVD
PASADENA CA
91101-2039
US

IV. Provider business mailing address

103 GRACE TER
PASADENA CA
91105-3428
US

V. Phone/Fax

Practice location:
  • Phone: 213-268-3495
  • Fax:
Mailing address:
  • Phone: 213-268-3495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number62697
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: