Basic Information
| Provider Information | |||||||||
| NPI: | 1437205390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RANDAL | ||||||||
| FirstName: | ADRIAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.A., M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 LISA LN RM 27 | ||||||||
| Address2: | |||||||||
| City: | PLEASANT HILL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945233902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252603599 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2400 LISA LN | ||||||||
| Address2: | |||||||||
| City: | PLEASANT HILL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256828000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 05/30/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | IMF76834 | CA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 106H00000X | 106671 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.