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NPI Code Detail

MEDICARE: JACQUELINE RICHTER M.D.

MEDICARE: JACQUELINE RICHTER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianG49286CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ89670ZOTHERCAPTAN

General Provider Information

NPI Number : 1144386137
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE RICHTER M.D.
Provider Business Mailing Address
First Line : 3260 SACRAMENTO ST
Second Line :
City : BERKELEY
State : CA
Zip : 94702-2739
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3260 SACRAMENTO ST
Second Line :
City : BERKELEY
State : CA
Zip : 94702-2739
Country : US
Telephone Number : 510-601-6060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 12/15/2021

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