Provider Demographics
NPI:1205908878
Name:CARO, RICHARD PETER II
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PETER
Last Name:CARO
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4414
Mailing Address - Country:US
Mailing Address - Phone:310-428-8488
Mailing Address - Fax:
Practice Address - Street 1:21445 CENTRE POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2684
Practice Address - Country:US
Practice Address - Phone:661-259-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC 248101YP2500X
CA50497106H00000X
CA32504103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3872OtherMENTAL HEALTH WORKER
CAMFT 50497OtherLICENSE
CALPCC 248OtherLICENSE