Provider Demographics
NPI:1992742787
Name:SHLEMMER, RICHARD LOUIS (PHD (PSYCHOLOGTY))
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LOUIS
Last Name:SHLEMMER
Suffix:
Gender:M
Credentials:PHD (PSYCHOLOGTY)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 OAK AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2455
Mailing Address - Country:US
Mailing Address - Phone:760-729-1457
Mailing Address - Fax:760-729-1457
Practice Address - Street 1:740 OAK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2455
Practice Address - Country:US
Practice Address - Phone:760-729-1457
Practice Address - Fax:760-729-1457
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10723103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical