Provider Demographics
NPI:1093968596
Name:LOWENTHAL, RICHARD L (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:LOWENTHAL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 KESTREL PL
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-0167
Mailing Address - Country:US
Mailing Address - Phone:530-902-7091
Mailing Address - Fax:206-337-1361
Practice Address - Street 1:7273 14TH AVE STE 120-B
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-3566
Practice Address - Country:US
Practice Address - Phone:916-383-0783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6725103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical