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General NPI Number Information
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NPI Number | 1881058402
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Entity Type | Individual
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Provider Name | MR. RICHARD SCOTT SYNOVEC
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Gender | Male
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Dates
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Enumeration Date | 04/09/2016
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1950 S SUNWEST LN
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3258
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Country | US
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Telephone | 909-252-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 33353 YUCAIPA BLVD
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City | YUCAIPA
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State | CA
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Zip | 92399-2018
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Country | US
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Telephone | 951-465-3664
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 109052
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License Number State | CA
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