Provider Demographics
NPI:1932729498
Name:RICHMOND, RAYMOND LLOYD (PHD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:LLOYD
Last Name:RICHMOND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1592 UNION ST # 83
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4505
Mailing Address - Country:US
Mailing Address - Phone:415-979-8005
Mailing Address - Fax:
Practice Address - Street 1:55 NEW MONTGOMERY ST STE 420
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-3429
Practice Address - Country:US
Practice Address - Phone:415-979-8005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13274103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY13274OtherSTATE