RICHARD ETTELSON (NPI# 1174569453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174569453 |
| Entity Type | Individual |
| Full Name | RICHARD ETTELSON |
| Credential | PHD |
| Practice Address |
10630 Town Center Dr Ste 120 Rancho Cucamonga CA 91730-6889 |
| Practice Telephone | 9099890901 |
| Practice Fax Number | 9099411087 |
| Mailing Telephone | 9099890901 |
| Mailing Fax Number | 9099411087 |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2018-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
D5418953 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10722 Arrow Rte, 314, Rancho Cucamonga, CA 917304808 | 9093673333 |
| Street Address |
10630 TOWN CENTER DR STE 120 |
| City | RANCHO CUCAMONGA |
| State | CA |
| Zip Code | 91730-6889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174050959 | New Horizons Therapy Group | Counselor | 10630 Town Center Dr Ste 120, Rancho Cucamonga, CA 91730-6889 | 2017-05-11 |
| 1861766354 | Ana P. Rodriguez | Marriage & Family Therapist | 10630 Town Center Dr Ste 120, Rancho Cucamonga, CA 91730-6889 | 2012-02-29 |
| 1558467258 | Steven Gilbert Gonzales | Social Worker | 10630 Town Center Dr Ste 120, Rancho Cucamonga, CA 91730-6889 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932722444 | Alliancerx Health Solutions, LLC. | Clinical Medical Laboratory | 9431 Haven Ave, Suite 100 #376, Rancho Cucamonga, CA 91730 | 2020-05-19 |
| 1346860194 | Wecare Dialysis Center | Clinic/Center | 8591 Grove Ave, Rancho Cucamonga, CA 91730 | 2020-04-22 |
| 1982235263 | Mel Latone Family Counseling, Inc. | Marriage & Family Therapist | 9033 Base Line Road, Suite M, Rancho Cucamonga, CA 91730 | 2020-01-27 |
| 1205471240 | Breena Nakamoto | Social Worker | 9645 Arrow Route, Building 5, Suite A, Rancho Cucamonga, CA 91730 | 2019-11-13 |
| 1497300180 | Laura Estela Le | Behavior Technician | 8350 Archilbald Ave Ste 110, Rancho Cucamonga, CA 91730 | 2019-08-08 |
| 1336792100 | Swan Psychological Services, Inc. | Psychologist | 8333 E. Foothill Blvd., Suite 109, Rancho Cucamonga, CA 91730 | 2019-07-22 |
| 1568023745 | Mariah Wright | Behavior Technician | 10532 Arcacia St, B-11, Rancho Cucamonga, CA 91730 | 2019-06-27 |
| 1770140378 | Amanda Ware | Clinic/Center | 9333 Fairway View Place Suite 101, Rancho Cucamonga, CA 91730 | 2019-05-20 |
| 1265995435 | Collaborative Autism Management Programs Inc. | Community/Behavioral Health | 9360 Santa Anita Ave Ste 104, Rancho Cucamonga, CA 91730 | 2019-04-12 |
| 1700361326 | Brittany Rhone | Behavioral Analyst | 933 Baseline Rd, Rancho Cucamonga, CA 91730 | 2018-09-28 |
| Find all providers in zip 91730 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795634 | Maya Boustani | Psychologist | 5441 Dundee Ct, Rancho Cucamonga, CA 91739-2604 | 2020-09-17 |
| 1336659002 | Abs Psychology Services California | Psychologist | 9600 Center Ave Ste 160, Rancho Cucamonga, CA 91730-5838 | 2017-10-06 |
| 1699187906 | Laura Thoreson | Psychologist | 11100 4th St Apt G301, Rancho Cucamonga, CA 91730-0908 | 2014-05-21 |
| 1518398296 | David Nelson | Psychologist | 10950 Church St Apt 312, Rancho Cucamonga, CA 91730-8063 | 2013-12-06 |
| 1801196027 | Lisa Louise Hazelwood | Psychologist | 9500 Etiwanda Ave., West Valley Detention Center, Attn: Medical Srvcs/liberty Roc, Rancho Cucamonga, CA 91739 | 2010-10-22 |
| 1891810438 | Aurelio Enriquez Jr. | Psychologist | 9330 Baseline Rd Ste 108, Rancho Cucamonga, CA 91701-5827 | 2007-03-20 |
| 1396801304 | James A Grace | Psychologist | 10630 Town Center Drive, Suite #124, Rancho Cucamonga, CA 91730 | 2006-12-28 |
| 1952417289 | Martha Cecilia Masson | Psychologist | 9330 Base Line Road, Suite 103, Rancho Cucamonga, CA 91701-5827 | 2006-08-21 |
| 1265405195 | Geralyn Marie Phillips | Psychologist | 8439 White Oak Ave, #104, Rancho Cucamonga, CA 91730-3860 | 2006-02-10 |
| 1487633616 | Georgina Ines Lamphere Sullivan | Psychologist | 8253 White Oak Ave, Rancho Cucamonga, CA 91730-7671 | 2006-01-16 |
| Find all providers in RANCHO CUCAMONGA | ||||
| City | RANCHO CUCAMONGA |
| Zip Code | 91730 |
Please comment or provide details below to improve the information on RICHARD ETTELSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.