Mr Douglass Richardson, MSPSY, CADC III is a
Community Health Worker based in Stockton, California. Mr Douglass Richardson is licensed to practice in California (license number BII00640223) and his current practice location is
620 N Aurora St Ste 1, Stockton, California. He can be reached at his office (for appointments etc.) via phone at
(209) 468-9370.
NPI number for Mr Douglass Richardson is 1609346402 and his current mailing address is 12935 Alcosta Blvd Unit 3882, San Ramon, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1609346402.
Healthcare Provider's Profile
| Full Name | Mr Douglass Richardson |
|---|
| Gender | Male |
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| Speciality | Community Health Worker |
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| Location | 620 N Aurora St Ste 1, Stockton, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1609346402
- Provider Enumeration Date: 12/05/2018
- Last Update Date: 07/22/2024
Medical Identifiers
Medical identifiers for Mr Douglass Richardson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609346402 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | BII00640223 (California) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | BII00640223 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Douglass Richardson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Douglass Richardson, MSPSY, CADC III
12935 Alcosta Blvd Unit 3882,
San Ramon, CA 94583-6181
Ph: (209) 696-1125 | Mr Douglass Richardson, MSPSY, CADC III
620 N Aurora St Ste 1,
Stockton, CA 95202-2276
Ph: (209) 468-9370 |
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