Provider Demographics
NPI:1235556580
Name:RICHARD C. VIEILLE, JR.
Entity Type:Organization
Organization Name:RICHARD C. VIEILLE, JR.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:CONSTANT
Authorized Official - Last Name:VIEILLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:831-622-9877
Mailing Address - Street 1:26335 CARMEL RANCHO BLVD
Mailing Address - Street 2:SUITE #7
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8876
Mailing Address - Country:US
Mailing Address - Phone:831-622-9877
Mailing Address - Fax:831-622-9858
Practice Address - Street 1:26335 CARMEL RANCHO BLVD
Practice Address - Street 2:SUITE #7
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8876
Practice Address - Country:US
Practice Address - Phone:831-622-9877
Practice Address - Fax:831-622-9858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA PSY 17561103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty