Healthcare Provider Details

I. General information

NPI: 1538815451
Provider Name (Legal Business Name): KAREN RICHARDSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NMRTC TWENTYNINE PALMS 1145 STURGIS ROAD
TWENTYNINE PALMS CA
92278
US

IV. Provider business mailing address

1145 STURGIS ROAD
TWENTYNINE PALMS CA
92278
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-5761
  • Fax:
Mailing address:
  • Phone: 619-532-5761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101279305
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: