Provider Demographics
NPI:1134210917
Name:REICHARD, RONALD WILLIAM (MA)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WILLIAM
Last Name:REICHARD
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:680 TELEGRAPH CANYON ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-6552
Mailing Address - Country:US
Mailing Address - Phone:619-421-7560
Mailing Address - Fax:619-421-4811
Practice Address - Street 1:680 TELEGRAPH CANYON ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-6552
Practice Address - Country:US
Practice Address - Phone:619-421-7560
Practice Address - Fax:619-421-4811
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT41073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist