Provider Demographics
NPI:1689303356
Name:HORN, RICHARD ALLEN SR (CCAPP)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALLEN
Last Name:HORN
Suffix:SR
Gender:
Credentials:CCAPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3501
Mailing Address - Country:US
Mailing Address - Phone:530-631-0814
Mailing Address - Fax:
Practice Address - Street 1:285 4TH ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3501
Practice Address - Country:US
Practice Address - Phone:530-631-0814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1464470322101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)