Individual
WAYNE B RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
503 S PERSHING AVE, STOCKTON, CA 95203-3236
(209) 810-5864
Mailing address
3120 E ANITA ST, STOCKTON, CA 95205-3905
(209) 415-0315
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
05/09/2025
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