Individual
DR. RANDY A. RHOAD
Active
Individual
DR. RANDY A. RHOAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002751
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y131C01
MEDICARE INDIVIDUAL PTAN
VA
05
—
010062691
—
VA
01
—
C10841
MEDICARE GROUP PTAN
VA
Enumeration date
11/22/2006
Last updated
02/06/2025
Update your record
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