Provider Demographics
NPI:1538302773
Name:ROMERO, RICHARD CARL (BA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CARL
Last Name:ROMERO
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 WATSON PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-4037
Mailing Address - Country:US
Mailing Address - Phone:562-421-7200
Mailing Address - Fax:
Practice Address - Street 1:4010 WATSON PLAZA DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-4037
Practice Address - Country:US
Practice Address - Phone:562-421-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health