Provider Demographics
NPI:1881920064
Name:RICHARDSON, LENI (VN237400)
Entity type:Individual
Prefix:MS
First Name:LENI
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:VN237400
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 S UNION AVE SUITE ONE HALF
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307
Mailing Address - Country:US
Mailing Address - Phone:661-321-0234
Mailing Address - Fax:661-321-8256
Practice Address - Street 1:2614 TROPICAL AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2205
Practice Address - Country:US
Practice Address - Phone:661-717-7064
Practice Address - Fax:661-321-9856
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN237400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)