Basic Information
| Provider Information | |||||||||
| NPI: | 1104197177 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICHARDSON | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1637 WHITEASH AVE | ||||||||
| Address2: | |||||||||
| City: | CLOVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936195032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5593606679 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 21633 AVENUE 24 | ||||||||
| Address2: | |||||||||
| City: | CHOWCHILLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936109650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596656100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2012 | ||||||||
| LastUpdateDate: | 01/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY22745 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.