Basic Information
Provider Information
NPI: 1295224459
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RICHARDS
FirstName: MARGARET
MiddleName: LOUISE
NamePrefix: MRS.
NameSuffix:  
Credential: REGISTERED NURSE
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 406
Address2:  
City: PAUMA VALLEY
State: CA
PostalCode: 920610406
CountryCode: US
TelephoneNumber: 7607491410
FaxNumber:  
Practice Location
Address1: 50100 GOLSH RD
Address2:  
City: VALLEY CENTER
State: CA
PostalCode: 920825338
CountryCode: US
TelephoneNumber: 7607491410
FaxNumber: 7607492151
Other Information
ProviderEnumerationDate: 05/03/2018
LastUpdateDate: 05/03/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC1500X288341CAY Nursing Service ProvidersRegistered NurseCommunity Health

No ID Information.


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