Ettelson, Richard

Ettelson, Richard is an individual health care provider with primary practice located at 10630 Town Center Dr Ste 120 , Rancho Cucamonga CA 91730-6889. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Ettelson, Richard can be contacted via phone (909) 989-0901.

Contact Information

Primary practice address
10630 Town Center Dr Ste 120 Rancho Cucamonga CA 91730-6889
Phone: (909) 989-0901
Fax: (909) 941-1087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X D5418953 California

Profile Details

NPI number 1174569453
LBN Legal business name Ettelson, Richard
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Sep 18th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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