Provider Demographics
NPI:1396814505
Name:ARELLANO, RICHARD PHILLIP (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PHILLIP
Last Name:ARELLANO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3340 KEMPER ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4906
Mailing Address - Country:US
Mailing Address - Phone:619-758-1433
Mailing Address - Fax:619-759-9823
Practice Address - Street 1:3340 KEMPER ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4906
Practice Address - Country:US
Practice Address - Phone:619-758-1433
Practice Address - Fax:619-759-9823
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA635871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical