Healthcare Provider Details
I. General information
NPI: 1629126941
Provider Name (Legal Business Name): RICHARD JOSEPH STREIFER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1425 S. BROADWAY
WALNUT CREEK CA
94596-1377
US
IV. Provider business mailing address
1425 S. BROADWAY
WALNUT CREEK CA
94596-1377
US
V. Phone/Fax
- Phone: 925-295-5243
- Fax:
- Phone: 925-295-5243
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PSY6563 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: