Provider Demographics
NPI:1932326907
Name:PREUIT, RICHARD ALAN
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALAN
Last Name:PREUIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4217
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-0217
Mailing Address - Country:US
Mailing Address - Phone:626-919-5903
Mailing Address - Fax:
Practice Address - Street 1:444 E HUNTINGTON DR
Practice Address - Street 2:SUITE 333
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-6203
Practice Address - Country:US
Practice Address - Phone:626-919-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35775106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist