Provider Demographics
NPI:1497147904
Name:RICHMOND, JOSHUA C (RP)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:C
Last Name:RICHMOND
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6464 W SUNSET BLVD
Mailing Address - Street 2:SUITE # 845
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-8001
Mailing Address - Country:US
Mailing Address - Phone:323-391-1305
Mailing Address - Fax:
Practice Address - Street 1:6464 W SUNSET BLVD
Practice Address - Street 2:SUITE # 845
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-8001
Practice Address - Country:US
Practice Address - Phone:323-391-1305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-21
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARP 242102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst