Provider Demographics
NPI:1245482769
Name:OLIVAREZ, RICHARD J (CADC II)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:OLIVAREZ
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6847 HASKELL AVE
Mailing Address - Street 2:UNIT #2
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-5064
Mailing Address - Country:US
Mailing Address - Phone:818-381-2084
Mailing Address - Fax:
Practice Address - Street 1:18646 OXNARD STREET
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-381-2084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA8354701101YA0400X
CA22611101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA8354701OtherCALIFORNIA ASSOCIATION OF DRUG & ALCOHOL COUNSELORS