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General NPI Number Information
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NPI Number | 1235556580
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Entity Type | Organization
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Legal Business Name | RICHARD C. VIEILLE, JR.
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 26335 CARMEL RANCHO BLVD SUITE #7
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City | CARMEL
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State | CA
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Zip | 93923-8876
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Country | US
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Telephone | 831-622-9877
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Fax | 831-622-9858
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Provider Business Mailing Address
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Address Line | 26335 CARMEL RANCHO BLVD SUITE #7
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City | CARMEL
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State | CA
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Zip | 93923-8876
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Country | US
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Telephone | 831-622-9877
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Fax | 831-622-9858
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. RICHARD CONSTANT VIEILLE JR.
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Credential | PHD
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Telephone | 831-622-9877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | CA PSY 17561
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License Number State | CA
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