Provider Demographics
NPI:1427065895
Name:MOSER, RICHARD KEVIN (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KEVIN
Last Name:MOSER
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 1:201 KENT AVE
Mailing Address - Street 2:#1
Mailing Address - City:KENTFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2542
Mailing Address - Country:US
Mailing Address - Phone:415-948-6604
Mailing Address - Fax:415-409-4814
Practice Address - Street 1:2142 SUTTER ST
Practice Address - Street 2:#2
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3120
Practice Address - Country:US
Practice Address - Phone:415-948-6604
Practice Address - Fax:415-409-4814
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16548103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical