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General NPI Number Information
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NPI Number | 1174334155
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Entity Type | Individual
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Provider Name | MR. RICHARD K HAGAMAN II
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Gender | Male
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 30125 AGOURA RD STE F
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4337
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Country | US
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Telephone | 805-659-8429
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Fax |
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Provider Business Mailing Address
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Address Line | 6231 LE SAGE AVE
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-1327
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Country | US
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Telephone | 310-435-2309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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