Provider Demographics
NPI:1255816344
Name:RICHTER-STAUFFER, KATHLEEN
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:RICHTER-STAUFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 SHADELANDS DR BLDG 10
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2538
Mailing Address - Country:US
Mailing Address - Phone:650-376-4230
Mailing Address - Fax:
Practice Address - Street 1:1633 BAYSHORE HWY
Practice Address - Street 2:STE. 155
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1544
Practice Address - Country:US
Practice Address - Phone:650-376-4230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker