Individual
VICKI SUE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8660
Mailing address
808 PRAIRIE DUNES DR, LATHROP, CA 95330-9008
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT31714
CA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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