Provider Demographics
NPI:1598526154
Name:ENGELN, RICHARD GARMAN (PHD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:GARMAN
Last Name:ENGELN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 R ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1312
Mailing Address - Country:US
Mailing Address - Phone:559-225-4910
Mailing Address - Fax:
Practice Address - Street 1:1055 R ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1312
Practice Address - Country:US
Practice Address - Phone:559-225-4910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY3981103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical