Individual
EDWARD RICHARDSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 613-0330
Mailing address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 613-0330
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
05/22/2025
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