Healthcare Provider Details

I. General information

NPI: 1063543619
Provider Name (Legal Business Name): RICHARD G. YOUNG, PH.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7177 BROCKTON AVE SUITE 335
RIVERSIDE CA
92506-2631
US

IV. Provider business mailing address

7177 BROCKTON AVE SUITE 335
RIVERSIDE CA
92506-2631
US

V. Phone/Fax

Practice location:
  • Phone: 951-369-7288
  • Fax: 951-369-1064
Mailing address:
  • Phone: 951-369-7288
  • Fax: 951-369-1064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC13030
License Number StateCA

VIII. Authorized Official

Name: MRS. NANCY S YOUNG
Title or Position: PRACTICE MANAGER
Credential:
Phone: 951-369-7288