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NPI Code Detail

MEDICARE: MISS GRETCHEN MONIQUE RICHARDSON

MEDICARE: MISS GRETCHEN MONIQUE RICHARDSON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1497805865
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS GRETCHEN MONIQUE RICHARDSON
Provider Business Mailing Address
First Line : 3259 SAN JOSE AVE
Second Line :
City : DALY CITY
State : CA
Zip : 94014-1077
Country : US
Telephone Number : 650-755-2340
Fax Number :
Provider Business Practice Location Address
First Line : 890 HAYES ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94117-2615
Country : US
Telephone Number : 415-701-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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Directions to “ MISS GRETCHEN MONIQUE RICHARDSON ” Practice Location

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