Provider Demographics
NPI:1780854364
Name:RICHARD, LANALGREE (CAS)
Entity Type:Individual
Prefix:MS
First Name:LANALGREE
Middle Name:
Last Name:RICHARD
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1963 N E ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-3919
Mailing Address - Country:US
Mailing Address - Phone:909-881-6146
Mailing Address - Fax:909-881-3479
Practice Address - Street 1:1963 N E ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-3919
Practice Address - Country:US
Practice Address - Phone:909-881-6146
Practice Address - Fax:909-881-3479
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5731101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)