Healthcare Provider Details

I. General information

NPI: 1578695268
Provider Name (Legal Business Name): RICHARD J LAPERRIERE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 E MAIN ST
VENTURA CA
93001-2660
US

IV. Provider business mailing address

24 E MAIN ST
VENTURA CA
93001-2660
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6919
  • Fax: 805-652-0868
Mailing address:
  • Phone: 805-652-6919
  • Fax: 805-652-0868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: