Provider Demographics
NPI:1588762777
Name:HANDLEY, RICHARD TODD (PA-C, MPAS)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:TODD
Last Name:HANDLEY
Suffix:
Gender:M
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26912 SANTA YNEZ WAY
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4969
Mailing Address - Country:US
Mailing Address - Phone:818-679-3363
Mailing Address - Fax:
Practice Address - Street 1:23929 MCBEAN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4467
Practice Address - Country:US
Practice Address - Phone:661-254-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant