Provider Demographics
NPI:1982975660
Name:WILMINGTON RICHEE, KAMARR AVIDON (MC)
Entity Type:Individual
Prefix:DR
First Name:KAMARR
Middle Name:AVIDON
Last Name:WILMINGTON RICHEE
Suffix:
Gender:M
Credentials:MC
Other - Prefix:DR
Other - First Name:KAMARR
Other - Middle Name:
Other - Last Name:RICHEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MC
Mailing Address - Street 1:11551 FAYE AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-1948
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 E 1ST ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4007
Practice Address - Country:US
Practice Address - Phone:714-542-3581
Practice Address - Fax:714-542-2246
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)