Healthcare Provider Details
I. General information
NPI: 1578761797
Provider Name (Legal Business Name): RICHA AGGARWAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/10/2007
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
446 N WESTHILL BLVD SUITE E
APPLETON WI
54914
US
IV. Provider business mailing address
PO BOX 19070
GREEN BAY WI
54307-9070
US
V. Phone/Fax
- Phone: 920-843-9162
- Fax: 920-610-7190
- Phone: 920-496-4700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 120050 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 41833 |
| License Number State | IA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | 65774-20 |
| License Number State | WI |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: