Healthcare Provider Details

I. General information

NPI: 1164348017
Provider Name (Legal Business Name): ANNA ELZBIETA RICHMON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HUGH CARGILL RD
CONCORD MA
01742-5611
US

IV. Provider business mailing address

125 HUGH CARGILL RD
CONCORD MA
01742-5611
US

V. Phone/Fax

Practice location:
  • Phone: 858-353-2555
  • Fax:
Mailing address:
  • Phone: 858-353-2555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number07339
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: