Provider Demographics
NPI:1841886819
Name:RICHEY, SAVANNAH MARIE
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MARIE
Last Name:RICHEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:MARIE
Other - Last Name:VASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1717 S CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-4798
Mailing Address - Country:US
Mailing Address - Phone:559-453-8050
Mailing Address - Fax:
Practice Address - Street 1:1717 S CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-4798
Practice Address - Country:US
Practice Address - Phone:559-453-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12310101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional