Provider Demographics
NPI:1184895377
Name:LABELLE, RICHARD (PSY D)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:LABELLE
Suffix:
Gender:M
Credentials:PSY D
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 1686
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-6686
Mailing Address - Country:US
Mailing Address - Phone:925-413-7585
Mailing Address - Fax:
Practice Address - Street 1:1789 W YOSEMITE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-5160
Practice Address - Country:US
Practice Address - Phone:209-858-7765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20008103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical