Healthcare Provider Details

I. General information

NPI: 1790695229
Provider Name (Legal Business Name): CANDICE S RICHARDSON, RICHARDSON THERAPY AND MEDICAL TRANSPORTATION CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5119 LISA WAY
SANTA ROSA CA
95409-3744
US

IV. Provider business mailing address

PO BOX 9329
SANTA ROSA CA
95405-1329
US

V. Phone/Fax

Practice location:
  • Phone: 707-888-2048
  • Fax: 707-888-2048
Mailing address:
  • Phone: 707-888-2048
  • Fax: 707-888-2048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CANDICE RICHARDSON
Title or Position: CEO
Credential: LCSW
Phone: 707-888-2048