Basic Information
| Provider Information | |||||||||
| NPI: | 1780757823 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHARDS | ||||||||
| FirstName: | CAROLE | ||||||||
| MiddleName: | JOY | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CPNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1441 E 17TH ST | ||||||||
| Address2: | |||||||||
| City: | NATIONAL CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919505018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194776162 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8010 FROST ST | ||||||||
| Address2: | SUITE 414 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921232778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8589667711 | ||||||||
| FaxNumber: | 8589667712 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 363LP0200X | 10775 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.