Provider Demographics
NPI:1235323106
Name:RICHARDS, SUMMER DANYELL (MA)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:DANYELL
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:SUMMER
Other - Middle Name:DANYELL
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1908 BUSINESS CENTER DR STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3468
Mailing Address - Country:US
Mailing Address - Phone:909-890-5930
Mailing Address - Fax:
Practice Address - Street 1:18245 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2217
Practice Address - Country:US
Practice Address - Phone:760-503-4393
Practice Address - Fax:760-515-6105
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMF78347106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist