Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Douglass Richardson, MSPSY, CADCIII

Individual provider Community Health Worker · NPI 1609346402

Mr. Douglass Richardson, MSPSY, CADCIII is a Community Health Worker in Stockton, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018
Specialties on file
4
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Practice location Address checks out

620 N Aurora St Ste 1
Stockton, CA 95202-2276
Phone: (209) 468-9370
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Day Training/Habilitation Specialist (primary) Taxonomy 373H00000X · Licence BII00640223 (CA)
Community Health Worker Taxonomy 172V00000X · Licence BII00640223 (CA)
Community Health Worker Taxonomy 172V00000X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence BII00640223 (CA)

Record details

NPI number1609346402
Entity typeIndividual (Type 1)
GenderMale
Credentials MSPSY , CADCIII
Sole proprietorYes
NPI enumeratedDecember 5, 2018
Last updated in NPPESApril 2, 2025
Certification dateApril 2, 2025

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