Provider Demographics
NPI:1922311356
Name:ADAMS-TOWNSEND, RICKY BOOTS (RICKY TOWNSEND)
Entity Type:Individual
Prefix:
First Name:RICKY
Middle Name:BOOTS
Last Name:ADAMS-TOWNSEND
Suffix:
Gender:M
Credentials:RICKY TOWNSEND
Other - Prefix:
Other - First Name:RICKY
Other - Middle Name:BOOTS
Other - Last Name:TOWNSEND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RICKY TOWNSEND
Mailing Address - Street 1:232 E GISH RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-4706
Mailing Address - Country:US
Mailing Address - Phone:408-379-3790
Mailing Address - Fax:
Practice Address - Street 1:232 E GISH RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-4706
Practice Address - Country:US
Practice Address - Phone:408-379-3790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist