Provider Demographics
NPI:1467669945
Name:STESS, RICHARD
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:STESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 DUTCH VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1016
Mailing Address - Country:US
Mailing Address - Phone:415-456-7925
Mailing Address - Fax:
Practice Address - Street 1:STS COMPANY, 655 REDWOOD HWY.
Practice Address - Street 2:SUITE 203
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941
Practice Address - Country:US
Practice Address - Phone:415-381-4602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1339213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery