Provider Demographics
NPI:1104138130
Name:STARRETT, RICHARD ALTON (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALTON
Last Name:STARRETT
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Gender:M
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:793 E FOOTHILL BLVD STE A
Mailing Address - Street 2:#179
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1699
Mailing Address - Country:US
Mailing Address - Phone:805-771-9868
Mailing Address - Fax:805-771-9868
Practice Address - Street 1:24511 W JAYNE AVE
Practice Address - Street 2:BOX 5000
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9503
Practice Address - Country:US
Practice Address - Phone:559-934-3099
Practice Address - Fax:559-934-3095
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 13628103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist