Provider Demographics
NPI:1841469129
Name:VOGEL, RICHARD M (MFT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:VOGEL
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4010 CALLE SONORA OESTE
Mailing Address - Street 2:UNIT 2A
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-3292
Mailing Address - Country:US
Mailing Address - Phone:949-830-8165
Mailing Address - Fax:949-581-4420
Practice Address - Street 1:23547 MOULTON PKWY
Practice Address - Street 2:SUITE 209
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1947
Practice Address - Country:US
Practice Address - Phone:949-690-6846
Practice Address - Fax:949-581-4420
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM15007106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist