Provider Demographics
NPI:1619178530
Name:CONCEPCION, RICHELLE SARMIENTO (PSYD)
Entity Type:Individual
Prefix:
First Name:RICHELLE
Middle Name:SARMIENTO
Last Name:CONCEPCION
Suffix:
Gender:F
Credentials:PSYD
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Other - Credentials:
Mailing Address - Street 1:BUILDING H-100 SANTA MARGARITA ROAD
Mailing Address - Street 2:NAVAL HOSPITAL CAMP PENDLETON
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055-9151
Mailing Address - Country:US
Mailing Address - Phone:760-725-8882
Mailing Address - Fax:760-725-1267
Practice Address - Street 1:BUILDING H-101 SANTA MARGARITA ROAD
Practice Address - Street 2:NAVAL HOSPITAL CAMP PENDLETON
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-9151
Practice Address - Country:US
Practice Address - Phone:760-725-8882
Practice Address - Fax:760-725-1267
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2012-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY24291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health