Provider Demographics
NPI:1770524761
Name:RICHMOND, NANCY MCLAUGHLIN (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:MCLAUGHLIN
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 LINCOLN BLVD
Mailing Address - Street 2:APT 470
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6900
Mailing Address - Country:US
Mailing Address - Phone:949-307-4684
Mailing Address - Fax:
Practice Address - Street 1:4750 LINCOLN BLVD
Practice Address - Street 2:APT 470
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6900
Practice Address - Country:US
Practice Address - Phone:949-307-4684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2123364SP0808X
CA15292363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner