Individual
RICHARD BARDONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDRC
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-4610
Mailing address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-4610
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
20255
CA
175T00000X
Peer Specialist
Primary
MPSS-SOZKEW
CA
372600000X
Adult Companion
—
CA
Other
Enumeration date
05/02/2025
Last updated
10/21/2025
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