Healthcare Provider Details

I. General information

NPI: 1629993605
Provider Name (Legal Business Name): RICHARD PATRICK FOSS II CMPSS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 W 9TH ST
UPLAND CA
91786-5979
US

IV. Provider business mailing address

1661 TIELO ST
BEAUMONT CA
92223-3253
US

V. Phone/Fax

Practice location:
  • Phone: 909-476-2023
  • Fax:
Mailing address:
  • Phone: 626-464-7834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMPSS-LGVKCA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: