Individual
BRYAN W RICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., LMFT
Contact information
Practice address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-7503
Mailing address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-7503
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY27355
CA
106H00000X
Marriage & Family Therapist
MFC 40827
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC70042F
MEDI-CAL PTAN GROUP#
CA
01
—
FHC70044F
MEDI-CAL PTAN GROUP#
CA
01
—
ZZZ91891Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
01
—
ZZZ91892Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
01
—
ZZZ92069Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
Enumeration date
11/10/2006
Last updated
07/06/2016
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